Organization
K MCDANIEL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAY K MCDANIEL NP (PRESIDENT)
(601) 636-0097
Entity
Organization
Contact information
Practice address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-0097
(601) 629-9969
Mailing address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-0097
(601) 629-9969
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R829001
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00778511
—
MS
Enumeration date
04/03/2014
Last updated
06/19/2014
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