Individual
KIMBERLY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1410 JEFFERSON ST, LAUREL, MS 39440-4243
(601) 425-7522
(601) 649-3551
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7522
(601) 649-3551
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
R874680
MS
363LF0000X
Family Nurse Practitioner
Primary
874680
MS
Other
Enumeration date
12/09/2015
Last updated
01/25/2021
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