Individual
AMANDA KITCHENS BOYANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
971 LAKELAND DR STE 353, JACKSON, MS 39216
(601) 949-6990
(601) 949-6105
Mailing address
971 LAKELAND DR STE 353, JACKSON, MS 39216-4607
(601) 949-6990
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R804323
MS
Other
Enumeration date
05/05/2006
Last updated
12/13/2019
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