NPI:
1356701783
Provider Name:
KIDS FIRST PEDIATRIC & ADULT MEDICINE, LLC
Former Legal Business Name: KIDS FIRST PEDIATRIC CLINIC, LLC
Classification:
Clinical Nurse Specialist - 364SF0001X
Entity Type:
Organization
Specialization: Family Health
Address:
529 LAKE ST STE B
HAZLEHURST, MS
ZIP 39083
Phone:
(601) 668-8400
Get Directions
KIDS FIRST PEDIATRIC & ADULT MEDICINE, LLC is a family health clinical nurse specialist in Hazlehurst, MS. KIDS FIRST PEDIATRIC & ADULT MEDICINE, LLC NPI is 1356701783. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Kids First Pediatric Clinic, Llc.
The provider's business location address is:
529 LAKE ST STE B
HAZLEHURST, MS
ZIP 39083-226
Phone: (601) 668-8400
Fax: (601) 623-9246
The provider's authorized official is Tiffany Rochelle Jackson .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (601) 668-8400.
The enumeration date for this NPI number is 2/26/2016 and was last updated on 9/18/2021.