Individual
KIMBERLY ROGERS GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R813989
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07805026
—
MS
Enumeration date
04/27/2011
Last updated
03/25/2021
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