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General NPI Number Information
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NPI Number | 1174440762
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Entity Type | Individual
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Provider Name | KAMRYN ORLIVIYAH RHUBI NELSON
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Gender | Female
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 116 E CANAL ST
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City | PICAYUNE
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State | MS
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Zip | 39466-4506
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Country | US
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Telephone | 769-926-1137
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Fax |
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Provider Business Mailing Address
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Address Line | 448 COUNTY FARM LN NE
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City | BROOKHAVEN
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State | MS
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Zip | 39601-9302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | M11554
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License Number State | MS
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