Ross, Kymberly Raven

Ross, Kymberly Raven is an sole proprietor health care provider with primary practice located at 301 Jackson Ave W , Oxford MS 38655-2154. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Ross, Kymberly Raven can be contacted via phone (662) 234-6464.

Contact Information

Primary practice address
301 Jackson Ave W Oxford MS 38655-2154
Phone: (662) 234-6464
Fax: (662) 234-6475
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 1116194 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APN0000010481 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R878897 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R878897 Mississippi

Profile Details

NPI number 1437242724
LBN Legal business name Ross, Kymberly Raven
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2006
Last updated Dec 30th, 2019 - 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 1437242724 NPPES
Mississippi MEDICAID 06759284

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