Healthcare Provider Details

I. General information

NPI: 1477477040
Provider Name (Legal Business Name): KIMBERLY LAUREN HENDRIX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BAPTIST MEMORIAL CIR STE 201
OXFORD MS
38655-4476
US

IV. Provider business mailing address

8060 WOLF RIVER BLVD
GERMANTOWN TN
38138-1727
US

V. Phone/Fax

Practice location:
  • Phone: 662-636-2400
  • Fax: 662-236-0083
Mailing address:
  • Phone: 901-271-1000
  • Fax: 901-271-4187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908581
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: