Healthcare Provider Details

I. General information

NPI: 1376157099
Provider Name (Legal Business Name): KATHRYN TAYLOR PARVIN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 LAKELAND DR
FLOWOOD MS
39232-9513
US

IV. Provider business mailing address

300 CANDLEWOOD CT
CANTON MS
39046-4500
US

V. Phone/Fax

Practice location:
  • Phone: 601-355-1234
  • Fax:
Mailing address:
  • Phone: 601-551-5181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number903867
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number903867
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: