Individual
KAMIKA WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7040 WIND STONE BLVD STE 150, OLIVE BRANCH, MS 38654-9090
(662) 874-5828
(662) 874-5870
Mailing address
PO BOX 515, CORDOVA, TN 38088-0515
(901) 484-9099
(470) 222-2771
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
169468
TN
163W00000X
Registered Nurse
916499
MS
363L00000X
Nurse Practitioner
Primary
24058
TN
363LP2300X
Primary Care Nurse Practitioner
24058
TN
363LP2300X
Primary Care Nurse Practitioner
905658
MS
Other
Enumeration date
03/14/2018
Last updated
09/30/2025
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