Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellie Roberts

Individual provider Family Nurse Practitioner · NPI 1194519439

Kellie Roberts is a Nurse Practitioner in Hattiesburg, Mississippi. Qualified in 2024, 2 years ago. Practices with Hattiesburg Clinic PA, a 530-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
2
Licensed in
MS
In the registry since
2025
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Practice location Address checks out

415 S 28th Ave
Hattiesburg, MS 39401-7246
Phone: (601) 268-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 907202 (MS)

Record details

NPI number1194519439
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 9, 2025
Last updated in NPPESApril 9, 2025
Certification dateApril 7, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Hattiesburg Clinic Pa — 530 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Hattiesburg