Individual
MRS. KIMBERLY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401
(601) 579-5010
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5010
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902083
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07121734
—
MS
Enumeration date
07/12/2017
Last updated
08/24/2020
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