Individual
KIMBERLY B. OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
407 INTERCHANGE DR, FULTON, MS 38843-6029
(662) 205-5775
(662) 269-9201
Mailing address
407 INTERCHANGE DR, FULTON, MS 38843-6029
(662) 205-5775
(662) 269-9201
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903420
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
931617
—
MS
Enumeration date
09/06/2019
Last updated
05/28/2025
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