Provider Demographics
NPI:1225546344
Name:KIMBRELL, WENDI LAYNE (FNP, RN, CRRN, CBIS)
Entity Type:Individual
Prefix:MRS
First Name:WENDI
Middle Name:LAYNE
Last Name:KIMBRELL
Suffix:
Gender:F
Credentials:FNP, RN, CRRN, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 REGENT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2440
Mailing Address - Country:US
Mailing Address - Phone:972-580-8500
Mailing Address - Fax:972-255-3162
Practice Address - Street 1:4851 REGENT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2544
Practice Address - Country:US
Practice Address - Phone:972-580-8500
Practice Address - Fax:972-255-3162
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-11
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily