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KIMBERLY NICOLE PATRICK
NPI 1639685639
Licensed Practical Nurse in Petal, MS

Active since December 28, 2017
15 SUNLINE DR, PETAL, MS 39465(601) 325-1107 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 28, 2025, Dec 28, 2017 (2 updates tracked since 2017).

About Kimberly Nicole Patrick NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY NICOLE PATRICK (NPI 1639685639) is an individual licensed practical nurse in Petal, Mississippi, licensed in Mississippi (334167) and active in the NPI registry since December 2017.

NPPES Registry Identity

NPI1639685639
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameKIMBERLY NICOLE PATRICK
Location Address15 SUNLINE DRPetal, MS 39465-9029
Mailing Address635 Hampshire DrBrandon, MS 39047-7797 · (601) 325-1107
Phone(601) 325-1107
Sole ProprietorYes
Enumeration DateDecember 28, 2017
Last NPPES UpdateMay 28, 20252 updates tracked since enumeration
NPPES CertifiedMay 28, 2025
✔ NPI 1639685639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MS · 334167
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Also ListedRegistered Nurse · Community HealthTaxonomy 163WC1500X · License 931616 (MS)
15 SUNLINE DR, Petal, MS 39465
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Patrick's NPI number?

The NPI number for Kimberly Patrick is 1639685639. It was assigned to this individual provider in the NPPES registry on December 28, 2017.

Where is Kimberly Patrick located?

Kimberly Patrick practices at 15 Sunline Dr, Petal, MS 39465. The listed phone number is (601) 325-1107.

What is Kimberly Patrick's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kimberly Patrick was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.