Individual
KIMBERLY JOHNSON GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP
Contact information
Practice address
348 CROSSGATES BLVD STE 1500, BRANDON, MS 39042-2687
(601) 824-2236
(601) 825-2699
Mailing address
7215 S SIWELL RD, BYRAM, MS 39272-9776
(601) 373-2204
(601) 373-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
875256
MS
Other
Enumeration date
12/17/2018
Last updated
03/02/2023
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