Provider Demographics
NPI:1275846842
Name:HORTMAN, KIMBERLY (MSN, RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:HORTMAN
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 W. JEFFERSON
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165
Mailing Address - Country:US
Mailing Address - Phone:972-923-7070
Mailing Address - Fax:972-938-3318
Practice Address - Street 1:1405 W. JEFFERSON
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:972-923-7070
Practice Address - Fax:972-938-3318
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily