Organization
KIDNEY FOCUSED CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE DIANE BOYD NURSE PRACTITIONER (OWNER)
(601) 665-4429
Entity
Organization
Contact information
Practice address
2633 RIDGEWOOD RD STE 105, JACKSON, MS 39216-4962
(601) 665-4429
(601) 665-4429
Mailing address
702 PECAN CT, BRANDON, MS 39042-6012
(662) 719-9120
(601) 665-4429
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/15/2020
Last updated
04/22/2021
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