Provider Demographics
NPI:1407465420
Name:WILSON, KIMBERLY FRANCES (CD-L,PIC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:FRANCES
Last Name:WILSON
Suffix:
Gender:F
Credentials:CD-L,PIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10964
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76547-0964
Mailing Address - Country:US
Mailing Address - Phone:520-230-0287
Mailing Address - Fax:
Practice Address - Street 1:6911 DEORSAM LOOP
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6377
Practice Address - Country:US
Practice Address - Phone:520-230-0287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-26
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula