Individual
KIM T LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2569
(228) 867-4000
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 575-1194
(228) 575-2917
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905128
MS
Other
Enumeration date
02/10/2022
Last updated
01/16/2026
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