Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KIMBERLY GWEN METTETAL, C.F.N.P. CPMHNP
ActiveKIMBERLY GWEN METTETAL, C.F.N.P. CPMHNP is a Psychiatric/Mental Health Nurse Practitioner healthcare provider located in SOUTHAVEN, Mississippi. NPI 1194911453 is currently active in the NPPES registry. Verify at CMS.
Psychiatric/Mental Health Nurse Practitioner · SOUTHAVEN, MS
Registration Details
- NPI Number
- 1194911453
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 20, 2007 (18.862924133683 yrs)
- Last Updated
- Jul 14, 2025
- Licenses
-
R850409 (MS)2018026553 (MO)AP60842248 (WA)8391-33 (WI)2018 (OR)
Practice Information
- Address
-
8626 AIRWAYS BLVDSOUTHAVEN, MS, 386712603Browse MS providers · Browse ZIP 38671
- Phone
- 6627725937
- Fax
- 6627725940
- Primary Specialty
-
Psychiatric/Mental Health Nurse Practitioner
363LP0808X
- Additional Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Additional Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Additional Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Additional Specialty
- Psychiatric/Mental Health Nurse Practitioner
Other Psychiatric/Mental Health Nurse Practitioner Providers in SOUTHAVEN, MS
| Name | Credential | NPI |
|---|---|---|
| TERESA D KENDRICK | NP | 1437406485 |
| DR. KATELYN LEE CONNER | PMHNP-BC | 1760902712 |
| MS. TRACY ELLIS BURNS | PMHNP | 1235619206 |
| TANISHA MARTIN | — | 1649753161 |
| OLIVIA JANE BALL | PMHNP-BC | 1588208094 |
| AMANDA FOLSOM | PMHNP | 1851916837 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.