Individual
KIMYUANA JACKSON DORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, AGNP-C
Contact information
Practice address
215 KATHERINE DR STE A, FLOWOOD, MS 39232-9588
(601) 665-4162
(888) 398-1151
Mailing address
20 HOBO FORK RD, NATCHEZ, MS 39120-9025
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
904207
MS
Other
Enumeration date
10/11/2020
Last updated
02/28/2024
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