Individual
KIM M. TUMMINELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4253 DENNY AVENUE, PASCAGOULA, MS 39581
(228) 938-0109
(228) 938-0555
Mailing address
4253 DENNY AVENUE, PASCAGOULA, MS 39581
(228) 938-0109
(228) 938-0555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP06674
LA
363LF0000X
Family Nurse Practitioner
AP06674
LA
363LF0000X
Family Nurse Practitioner
Primary
R858093
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03072365
—
MS
Enumeration date
12/02/2011
Last updated
06/10/2016
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