Individual
MS. SANDRA KINNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
103 S 19TH AVE, HATTIESBURG, MS 39401-6171
(601) 544-4641
(601) 584-4053
Mailing address
PO BOX 1030, HATTIESBURG, MS 39403-1030
(601) 544-4641
(601) 584-4053
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R722863
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04535271
—
MS
Enumeration date
08/03/2006
Last updated
07/08/2007
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