Individual
KORKI S TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
140 MERT RICKMAN RD, COLUMBUS, MS 39702-7316
(662) 574-6136
Mailing address
140 MERT RICKMAN RD, COLUMBUS, MS 39702-7316
(662) 574-6136
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
875952
MS
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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