KIMYUANA JACKSON DORRIS PMHNP AGNP-C NPI 1184222374

NPI Information

  • NPI: 1184222374
  • Provider Name: KIMYUANA JACKSON DORRIS, PMHNP, AGNP-C
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 215 KATHERINE DR STE A
    FLOWOOD, MS
    ZIP 39232
  • Phone: (601) 665-4162

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NPI Details

Kimyuana Jackson Dorris, PMHNP, AGNP-C is an adult medicine family medicine in Flowood, MS with 6 years of experience. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. Kimyuana Jackson Dorris, PMHNP, AGNP-C NPI is 1184222374. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

215 KATHERINE DR STE A
FLOWOOD, MS
ZIP 39232-588
Phone: (601) 665-4162
Fax: (888) 398-1151

The NPI 1184222374 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/11/2020 and was last updated on 2/28/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0505XFamily MedicineAdult Medicine904207MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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