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General NPI Number Information
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NPI Number | 1972870053
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Entity Type | Organization
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Legal Business Name | RANKIN FAMILY PRACTICE INC
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 201 N COLLEGE ST SUITE 102
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City | BRANDON
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State | MS
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Zip | 39042-4437
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Country | US
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Telephone | 601-825-3074
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Fax | 601-825-7296
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Provider Business Mailing Address
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Address Line | 201 N COLLEGE ST SUITE 102
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City | BRANDON
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State | MS
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Zip | 39042-4437
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Country | US
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Telephone | 601-825-3074
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Fax | 601-825-7296
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Authorized Official
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Title or Position | CFNP
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Name | MRS. KIMBERLY OWEN LOE
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Credential | CFNP
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Telephone | 601-825-3074
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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 | R862120
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License Number State | MS
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