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General NPI Number Information
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NPI Number | 1487693305
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Entity Type | Individual
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Provider Name | MISSY ELAINE MIMS KIRKMAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 148 13TH ST SW STE 200
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City | LARGO
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State | FL
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Zip | 33770-3127
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Country | US
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Telephone | 727-450-3030
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Fax | 727-450-3031
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Provider Business Mailing Address
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Address Line | PO BOX 633
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City | LARGO
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State | FL
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Zip | 33779-0633
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Country | US
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Telephone | 646-670-7609
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Fax | 727-450-3031
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 128383
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11019775
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License Number State | FL
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