Individual
MS. KIMBERLY A.H. SUNDLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3606
(601) 579-5383
Mailing address
1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
(601) 264-3937
(601) 264-5930
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
3870
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
R813576
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02576323
—
MS
05
—
1083707814
—
VA
01
—
139180
TRIGON
VA
01
—
302I439809
MEDICARE
MS
01
—
3461546
UNITED HEALTHCARE
MS
01
—
484645
NCPPO
VA
01
—
8824103
CIGNA
MS
01
—
9840251
AETNA
MS
01
—
K142-0002
CARE FIRST 2005
VA
Enumeration date
10/02/2006
Last updated
03/14/2018
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