Kimberly Gwen Mettetal is a Southaven, Mississippi based nurse practitioner with 26 years of experience in Family. She completed her graduation in 1999. She may accept the Medicare-approved amount. Patients may be billed for more than the Medicare deductible and coinsurance. Active license number of Kimberly Gwen Mettetal is R850409 for Psych/Mental Health in Mississippi. Her current practice location is 8626 Airways Blvd, Southaven. Patients can reach her at 662-772-5937 or can fax her at 662-772-5940. Kimberly Gwen Mettetal is C.F.N.P. CPMHNP with specialization in Family and her NPI number (Unique professional ID assigned by NPPES) is 1194911453. Kimberly Gwen Mettetal delivers family-focused care which means she provides care for patients ranging from infants to the elderly and every age in between. Family Nurse Practitioner (FNP) are frequently the primary care provider for families, which means that they will not only diagnose conditions, but also treat them. FNPs perform physical exams, order diagnostic tests and procedures, diagnose and treat illness, prescribe needed medications, and teach their patients how to develop healthy lifestyles to promote health and prevent disease.
Complete Profile:
Kimberly Gwen Mettetal speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
7315925708
Enrollment ID:
I20180328002127
NPI Number:
1194911453
NPI Enumeration Date:
20 Sep, 2007
NPI Last Update On:
14 Jul, 2025
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kimberly Gwen Mettetal are as mentioned below.
License Number
Specialization
State
Status
R850409
Psych/Mental Health
Mississippi
Primary
R850409
Family
Mississippi
Secondary
2018026553
Psych/Mental Health
Missouri
Secondary
AP60842248
Psych/Mental Health
Washington
Secondary
8391-33
Psych/Mental Health
Wisconsin
Secondary
2018
Psych/Mental Health
Oregon
Secondary
5816
Psych/Mental Health
Minnesota
Secondary
AP136974
Psych/Mental Health
Texas
Secondary
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Kimberly Gwen Mettetal is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Lubbock Regional Mhmr Center (6800782376)
9
Texas Panhandle Mental Health Mental Retardation (0446200067)
9
Other Medical Identifiers:
Other legacy medical identifiers associated with Kimberly Gwen Mettetal such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
06787540
Medicaid
Mississippi
382605901
Medicaid
Texas
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.