Individual
MRS. AMELIA S KUYKENDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
499 GLOSTER CREEK VLG STE G1, TUPELO, MS 38801-4751
(662) 377-2663
Mailing address
4250 S EASON BLVD, TUPELO, MS 38801-6549
(662) 377-5265
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R864614
MS
163WR0006X
Registered Nurse First Assistant
864614
MS
363LF0000X
Family Nurse Practitioner
Primary
864614
MS
363LF0000X
Family Nurse Practitioner
F0812323
MS
Other
Enumeration date
07/09/2012
Last updated
12/03/2020
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