Katie Kyzar, ATC

Individual provider Active NPI Athletic Trainer · Raymond, MS

NPI 1467110601 · NPPES record last updated Dec 6, 2021

Key facts

NPI
1467110601
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
AT0779 (MS)
Practice address
608 Hinds Blvd
Raymond, MS 39154-8246
Phone
(601) 857-3325
NPI assigned
Dec 6, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AT0779MSMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT0779 MS Yes

Addresses

Primary practice location

608 Hinds Blvd
Raymond, MS 39154-8246

Mailing address

PO Box 1100
Raymond, MS 39154-1100
Phone (601) 498-4896

Other providers in Raymond, MS

All providers in Raymond, MS · Athletic Trainer in Mississippi

Sources for this page

Verify at the official NPI Registry.