Madison Klim
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Jackson, MS
NPI 1114798477 · NPPES record last updated Jan 15, 2024
Key facts
- NPI
- 1114798477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 2500 N State St
Jackson, MS 39216-4500 - Phone
- (601) 984-5012
- NPI assigned
- Jan 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5012
Other providers in Jackson, MS
- Kimberly Carson Kitchens
- Stacey Neubauer Kitchens
- Victoria Kivlan
- Patrick M Klar
- Karen H Klein
- KLM Healthcare Agency Inc
- Klyvora LLC
- Klyvora LLC
- Klyvora LLC
- Klyvora LLC
All providers in Jackson, MS · Student in an Organized Health Care Education/Training Program in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.