NPI 1396579512

Kendauris Burroughs

Practitioner Technician Kosciusko, MS

Practice location

Address: 106 W South St, Kosciusko, MS 39090-4414
Phone: (662) 770-0856

Registered specialties

Technician Primary

Nursing Service Related Providers Taxonomy 374700000X

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Registry record

NPI: 1396579512
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Aug 2024
Record last updated: 29 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.