Provider Demographics
NPI:1609019165
Name:TRIMM, KRISTI KAY (DO)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:KAY
Last Name:TRIMM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 HIGHLAND COLONY PKWY STE 219
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-6079
Mailing Address - Country:US
Mailing Address - Phone:601-707-3370
Mailing Address - Fax:
Practice Address - Street 1:1051 HIGHLAND COLONY PKWY STE E
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-7701
Practice Address - Country:US
Practice Address - Phone:601-707-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS22530207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine