| Doctor Name: | KAWANNA CORRINE MALONE |
| NPI Number: | 1639279425 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.F.N.P. |
| License Number: | R682403 |
| Business Practice Address: | 1495 Maple Rd Nettleton, MS - 388586026 |
| Business Phone Number: | 6629639146 |
| Business Fax Number: | 6629639186 |
| Mailing Address: | 361 Cr 122, NETTLETON |
| State: | MS |
| Postal Code: | 388586026 |
| Phone Number: | 6628251086 |
| Fax Number: | |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 03/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R682403 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |