KIMBERLY ROGERS GONZALES ACNP NPI 1275824088

NPI Information

NPI: 1275824088
Provider Name: KIMBERLY ROGERS GONZALES, ACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
415 S 28TH AVE
HATTIESBURG, MS
ZIP 39401
Phone: (601) 288-4329
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Kimberly Rogers Gonzales, ACNP is an acute care nurse practitioner in Hattiesburg, MS with 14 years of experience. Kimberly Rogers Gonzales, ACNP NPI is 1275824088. 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:

415 S 28TH AVE
HATTIESBURG, MS
ZIP 39401-246
Phone: (601) 288-4329
Fax: (601) 579-5240

The NPI 1275824088 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 4/27/2011 and was last updated on 3/25/2021.

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
1	363LA2100X	Nurse Practitioner	Acute Care	R813989	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	07805026	MEDICAID	MISSISSIPPI

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: 4/28/2024

NPI Synchronization or Removal

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