| Doctor Name: | MRS. KELLIE RONE CAUTHEN |
| NPI Number: | 1063716082 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MSN, NP-C |
| License Number: | R877290 |
| Business Practice Address: | 8613 Ms Highway 12 Ackerman, MS - 397358917 |
| Business Phone Number: | 6622854400 |
| Business Fax Number: | 6622859485 |
| Mailing Address: | 8613 Ms Highway 12, ACKERMAN |
| State: | MS |
| Postal Code: | 397358917 |
| Phone Number: | 6622854400 |
| Fax Number: | 6622859485 |
| NPI Enumeration Date: | 01/05/2011 |
| NPI Last Update Date: | 12/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R877290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |