Individual
KAITLIN GRANBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
102 MEDICAL PARK, HATTIESBURG, MS 39401-9080
(601) 261-5159
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-5159
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905268
MS
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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