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General NPI Number Information
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NPI Number | 1922822501
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Entity Type | Individual
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Provider Name | BRAXTON KYE MEEKS FNP
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Gender | Male
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 1507 W QUITMAN ST
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City | IUKA
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State | MS
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Zip | 38852-1133
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Country | US
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Telephone | 662-432-1000
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Fax | 662-432-1316
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Provider Business Mailing Address
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Address Line | 171 ROAD 1445
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City | MOOREVILLE
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State | MS
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Zip | 38857-8008
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Country | US
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Telephone | 662-416-7035
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 907818
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License Number State | MS
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