Provider Demographics
NPI:1225781651
Name:ALLEN, KIMBERLY ANN (APRN, FNP-C, RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:APRN, FNP-C, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-4690
Mailing Address - Country:US
Mailing Address - Phone:409-338-2952
Mailing Address - Fax:
Practice Address - Street 1:3727 N 16TH ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77632-4690
Practice Address - Country:US
Practice Address - Phone:094-920-4223
Practice Address - Fax:888-910-2061
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151442363LP2300X
TX901942163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care