Provider Demographics
NPI:1700566213
Name:KIMES, ANNE WALKER (PMHNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:WALKER
Last Name:KIMES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7609
Mailing Address - Country:US
Mailing Address - Phone:662-299-5551
Mailing Address - Fax:
Practice Address - Street 1:505 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:MS
Practice Address - Zip Code:39074-4033
Practice Address - Country:US
Practice Address - Phone:601-469-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906081363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health