Provider Demographics
NPI:1003130121
Name:HOUSTON, KIMBERLY C (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:C
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-3042
Mailing Address - Country:US
Mailing Address - Phone:919-742-2209
Mailing Address - Fax:919-742-1310
Practice Address - Street 1:1002 W 3RD ST
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3042
Practice Address - Country:US
Practice Address - Phone:919-742-2209
Practice Address - Fax:919-742-1310
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004661363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1003130121OtherNPI
NC203118OtherRN LICENSE
NC5004661OtherNURSE PRACTITIONER LICENSE
NC5004661OtherNURSE PRACTITIONER LICENSE