Individual
KIMBERLY P. RAYBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Contact information
Practice address
394 COURTHOUSE RD, SUITE A, GULFPORT, MS 39507-1865
(228) 896-4417
(228) 604-0121
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 864-8454
(228) 865-1457
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R867582
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04709739
—
MS
Enumeration date
03/03/2008
Last updated
07/10/2014
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