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Individual

KIMBERLEY STANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
845 INGRAM CIR N, GREENVILLE, MS 38701-8048
(662) 379-7716
Mailing address
845 INGRAM CIR N, GREENVILLE, MS 38701-8048
(662) 379-7716

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P319467
MS
372600000X
Adult Companion
376J00000X
Homemaker
376K00000X
Nurse's Aide

Other

Enumeration date
03/18/2015
Last updated
03/18/2015
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