Kinnan, Sandra

Kinnan, Sandra is an individual health care provider with primary practice located at 103 S 19Th Ave , Hattiesburg MS 39401-6171. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Kinnan, Sandra can be contacted via phone (601) 544-4641.

Contact Information

Primary practice address
103 S 19Th Ave Hattiesburg MS 39401-6171
Phone: (601) 544-4641
Fax: (601) 584-4053
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R722863 Mississippi

Profile Details

NPI number 1093722662
LBN Legal business name Kinnan, Sandra
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jul 8th, 2007 - about 17 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 1093722662 NPPES
Mississippi MEDICAID 04535271

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