Provider Demographics
NPI:1407383748
Name:HASTINGS, KIMBERLY MICHELLE (FNP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:MICHELLE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HEDGEROW LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-4474
Mailing Address - Country:US
Mailing Address - Phone:512-466-9660
Mailing Address - Fax:
Practice Address - Street 1:9301 ELM GROVE CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78736-7716
Practice Address - Country:US
Practice Address - Phone:512-466-9660
Practice Address - Fax:512-466-9660
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily