Individual
KIMBERLY JORDAN TUPPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
391 SOUTHCREST CIR STE 200, SOUTHAVEN, MS 38671-6729
(901) 271-1000
(901) 922-6718
Mailing address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 922-6718
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4214
TN
363A00000X
Physician Assistant
Primary
PA00741
MS
Other
Enumeration date
03/20/2020
Last updated
01/21/2026
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