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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KIMBERLY NICOLE PATRICK

Active Sole Proprietor

KIMBERLY NICOLE PATRICK is a Licensed Practical Nurse healthcare provider located in PETAL, Mississippi. NPI 1639685639 is currently active in the NPPES registry. Verify at CMS.

Licensed Practical Nurse · PETAL, MS

Registration Details

NPI Number
1639685639
Provider Type
Individual
Gender
Female
NPI Issued
Dec 28, 2017 (8.6514927437809 yrs)
Last Updated
May 28, 2025
Licenses
931616 (MS)
334167 (MS)
Sole Proprietor
Yes

Practice Information

Address
15 SUNLINE DR
PETAL, MS, 394659029
Browse MS providers · Browse ZIP 39465
Phone
6013251107
Primary Specialty
Licensed Practical Nurse
164W00000X
Additional Specialty
Licensed Practical Nurse
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.