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General NPI Number Information
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NPI Number | 1588775795
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Entity Type | Individual
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Provider Name | KIMSEY MICHELLE CAVALIER
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 149 DRINKWATER RD
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City | BAY ST LOUIS
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State | MS
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Zip | 39520-1658
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Country | US
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Telephone | 228-467-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 3503 MERCIER DR
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City | PASCAGOULA
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State | MS
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Zip | 39581-2235
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R871819
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License Number State | MS
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