Kimberly Robinson, FNP-C
Individual provider Active NPI Primary Care Nurse Practitioner · Shaw, MS
NPI 1124902432 · NPPES record last updated Aug 1, 2025
Key facts
- NPI
- 1124902432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 916543 (MS)
- Practice address
- 112 W Peeler Ave
Shaw, MS 38773-8710 - Phone
- (662) 754-3301
- Fax
- (662) 754-3301
- NPI assigned
- Aug 1, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 916543 | MS | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boa Vida Hospital of Aberdeen, Ms, LLC | Past | Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms, LLC | Past | Accepting new patients | |
| Boa Vida Hospital of Aberdeen, Ms LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 916543 | MS | Yes |
Addresses
Primary practice location
112 W Peeler Ave
Shaw, MS 38773-8710
Mailing address
112 W Peeler Ave
Shaw, MS 38773-8710
Phone (662) 754-3301
Other providers in Shaw, MS
- Maximum Care After Hours Clinic, LLC
- Corissa McClure
- Ronnie Lane Poe
- Preservers of Life Hospice
- Clifton Dewayne Reed
- La Robinson
- Shaw Community Care Clinic
- Shaw Community Care Clinic
- Shaw Family Medical, LLC
- Carmaleta L. Shaw
All providers in Shaw, MS · Primary Care Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2025. 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.