Organization
KIDS FIRST PEDIATRIC & ADULT MEDICINE, LLC
Active
Parent organization
KIDS FIRST PEDIATRIC & ADULT MEDICINE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIDS FIRST PEDIATRIC & ADULT MEDICINE, LLC
Authorized official
TIFFANY JACKSON FNP (FAMILY NURSE PRACTITIONER)
(601) 623-9245
Entity
Organization
Contact information
Practice address
404 RIVERWIND DR STE B-1, PEARL, MS 39208-5900
(601) 623-9245
(601) 623-9246
Mailing address
PO BOX 495, JACKSON, MS 39205-0495
(601) 623-9245
(601) 623-9246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
364SF0001X
Family Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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