Individual
KIMBERLY ANN TYNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
514 E WOODROW WILSON AVE STE F, JACKSON, MS 39216-4538
(601) 982-3132
(601) 982-3136
Mailing address
1824 AUGUST BND, MADISON, MS 39110-6825
(601) 941-3863
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R824497
MS
Other
Enumeration date
03/17/2016
Last updated
09/12/2019
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