Individual
KISHINA SHONTRELL SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
768 AVERY BLVD N, RIDGELAND, MS 39157-5219
(601) 487-6482
(601) 487-6528
Mailing address
1281 WOODDELL DR, JACKSON, MS 39212-4043
(601) 201-1971
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901734
MS
Other
Enumeration date
09/10/2016
Last updated
09/12/2016
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