Kids Avenue Pediatrics LLC
NPI #1154092690 in Brandon, Mississippi
Provider Information
- NPI Number
- 1154092690
- Entity Type
- Organization
- Organization Name
- Kids Avenue Pediatrics LLC
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Sep 24, 2021
- Last Updated
- Sep 24, 2021
Practice Location
- Address
- 1061 LAKE VILLAGE CIR STE D1
- City
- Brandon
- State
- Mississippi
- ZIP Code
- 39047-6723
- Phone
- (601) 941-0699
Authorized Official
- Name
- DR. APRIL DAWN RANDLE, FNP
- Title
- ADMINISTRATOR
- Phone
- (601) 941-0699
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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