Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Kimberlie La'Tasha Mabry, FNP-C

Individual provider Nurse Practitioner · NPI 1891422853

Mrs. Kimberlie La'Tasha Mabry, FNP-C is a Nurse Practitioner in Gautier, Mississippi. Qualified in 2021, 5 years ago. Practices with Calcasieu Urgent Care LLC, a 135-clinician group and accepts Medicare assignment. Licensed in Louisiana and Mississippi.

Years since qualifying
5
Licensed in
LA, MS
In the registry since
2022
Specialties on file
3
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

1509 Willowbend Dr
Gautier, MS 39553-7627
Phone: (228) 627-1223
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 905478 (MS)
Nurse Practitioner Taxonomy 363L00000X · Licence 905478 (MS)
Nurse Practitioner Taxonomy 363L00000X · Licence 227359 (LA)

Record details

NPI number1891422853
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedAugust 1, 2022
Last updated in NPPESJuly 18, 2023
Certification dateJuly 18, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Calcasieu Urgent Care Llc — 135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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