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Individual

MS. KIM WILLAMS TRUESDALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
139 NORTH OLIVER ST, BROOKSVILLE, MS 39739
(662) 738-4424
(662) 738-4615
Mailing address
6637 GREENFIELD DR, WEST POINT, MS 39773-6501
(662) 492-4307

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R576972
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00113993
MS
Enumeration date
11/16/2006
Last updated
12/01/2009
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