Individual
MRS. LACHASITY KIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2032 AUDUBON PL, SOUTHAVEN, MS 38672-9440
(662) 902-0817
Mailing address
2032 AUDUBON PL, SOUTHAVEN, MS 38672-9440
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23598
TN
Other
Enumeration date
12/06/2017
Last updated
06/16/2018
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