Individual
KAKAWONDA T HIBBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
702 HIGHWAY 82 E, INDIANOLA, MS 38751-2322
(662) 207-8492
(662) 887-7042
Mailing address
640 SUNFLOWER AVENUE EXT, INDIANOLA, MS 38751-2687
(662) 207-8492
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
HIBB-HIF5DC
MS
363LF0000X
Family Nurse Practitioner
Primary
HIBB-HIF5DC
MS
Other
Enumeration date
07/30/2021
Last updated
04/05/2022
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