MEDICARE: CHARITY KILGORE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	908091	MS

General Provider Information

NPI Number	:	1083572291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARITY KILGORE FNP

Provider Business Mailing Address
First Line	:	3166 E REED RD
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38703-9475
Country	:	US
Telephone Number	:	662-820-4371
Fax Number	:

Provider Business Practice Location Address
First Line	:	3166 E REED RD
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38703-9475
Country	:	US
Telephone Number	:	662-820-4371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ CHARITY KILGORE FNP” Practice Location

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