Healthcare Provider Details

I. General information

NPI: 1376241620
Provider Name (Legal Business Name): KAYLA TRULUCK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 METHODIST BLVD
HATTIESBURG MS
39402-1297
US

IV. Provider business mailing address

231 METHODIST BLVD
HATTIESBURG MS
39402-1297
US

V. Phone/Fax

Practice location:
  • Phone: 912-369-5437
  • Fax:
Mailing address:
  • Phone: 912-369-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number907479
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN29339
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN29339
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: