Healthcare Provider Details

I. General information

NPI: 1275384570
Provider Name (Legal Business Name): KASHONNA NORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 S OAK
RAYMOND MS
39154-4205
US

IV. Provider business mailing address

11 JASON CT
NATCHEZ MS
39120-8853
US

V. Phone/Fax

Practice location:
  • Phone: 601-915-2095
  • Fax: 601-851-3020
Mailing address:
  • Phone: 601-597-4989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number906630
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: