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1154092690
KIDS AVENUE PEDIATRICS LLC
BRANDON, MS
NPI
1154092690
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Entity Type
Organization
Authorized Contact
APRIL DAWN RANDLE
Administrator
601-941-0699
Organization Subpart ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
Enumeration Date
2021-09-24
Last Update Date
2021-09-24
Business Address
KIDS AVENUE PEDIATRICS LLC
1061 LAKE VILLAGE CIR STE D1
BRANDON, MS 39047-6723
Phone number: 601-941-0699
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Mailing Address
KIDS AVENUE PEDIATRICS LLC
1061 LAKE VILLAGE CIR STE D1
BRANDON, MS 39047-6723
Phone number: 601-941-0699
Copy
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