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Organization

KIDS FIRST PEDIATRIC & ADULT MEDICINE, LLC

Active
Other names
Kids First Pediatric Clinic, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY ROCHELLE JACKSON FNP (FAMILY NURSE PRACTITIONER)
(601) 668-8400
Entity
Organization

Contact information

Practice address
529 LAKE ST STE B, HAZLEHURST, MS 39083-2226
(601) 668-8400
(601) 623-9246
Mailing address
PO BOX 495, JACKSON, MS 39205-0495
(601) 668-8400

Taxonomy

Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
364SP0200X
Pediatric Clinical Nurse Specialist
R881238
MS

Other

Enumeration date
02/26/2016
Last updated
09/18/2021
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