Individual
KIMBERLY LASHAUN COKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
105 THOMAS LANE, NEW AUGUSTA, MS 39462-3946
(601) 606-0956
Mailing address
PO BOX 45, NEW AUGUSTA, MS 39462-0045
(601) 606-0956
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903064
MS
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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