Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 25922 | MS |
N | 207T00000X | Neurosurgeon | T-2728 | MS |
NPI | 1083054498 |
---|---|
Provider Name | Dr. Kelsey Angeline Walsh |
First Address | Flowood, MS 39232-9019 |
Second Address | Flowood, MS 39232-9019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2013 |
Last Update Date | 14/07/2020 |