Gonzales, Kimberly Rogers

Gonzales, Kimberly Rogers is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Gonzales, Kimberly Rogers can be contacted via phone (601) 288-4329.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 288-4329
Fax: (601) 579-5240
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X R813989 Mississippi

Profile Details

NPI number 1275824088
LBN Legal business name Gonzales, Kimberly Rogers
Credentials ACNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2011
Last updated Mar 25th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275824088 NPPES
Mississippi MEDICAID 07805026

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