Individual
MR. KEVIN WOODSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
309 AIRPORT RD S STE B, PEARL, MS 39208-6678
(769) 234-0770
Mailing address
107 VICTORIA LN, CLINTON, MS 39056-4031
(769) 234-0770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
917703
MS
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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