Individual
MRS. KIMBERLY IRBY DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4310 CHICOT ST, PASCAGOULA, MS 39581-4700
(228) 205-4737
(228) 205-4964
Mailing address
3709 OAK AVE, GULFPORT, MS 39507-3108
(228) 596-5301
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904287
MS
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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