Individual
KIMBERLY SHAVON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
433 N FIFTH ST, BROOKHAVEN, MS 39601-2925
(601) 754-3958
Mailing address
433 N FIFTH ST, BROOKHAVEN, MS 39601-2925
(601) 754-3958
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MS
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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