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General NPI Number Information
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NPI Number | 1275027443
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Entity Type | Individual
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Provider Name | KIMBERLY MYCHEL MCNAIR
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Gender | Female
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 5260 CEDAR PARK DR STE E2
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City | JACKSON
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State | MS
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Zip | 39206-4131
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Country | US
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Telephone | 601-966-1014
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Fax | 866-598-2650
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Provider Business Mailing Address
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Address Line | 1225 HUBB RD
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City | BOLTON
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State | MS
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Zip | 39041-9149
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6798
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License Number State | MS
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