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General NPI Number Information
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NPI Number | 1952867574
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Entity Type | Individual
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Provider Name | ERIKA CECELIA KINMAN FNP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 611 ALCORN DR
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City | CORINTH
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State | MS
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Zip | 38834-9388
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Country | US
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Telephone | 662-293-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 910 HOLLY HILL DR
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City | TUPELO
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State | MS
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Zip | 38801-2362
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Country | US
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Telephone | 479-647-6019
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 217357
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 903046
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 217357
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License Number State | AR
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