Provider Demographics
NPI:1467693713
Name:KENNEY, KIMBERLY SLAYTON (APRN, CNS)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SLAYTON
Last Name:KENNEY
Suffix:
Gender:F
Credentials:APRN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 W 32ND ST STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1917
Mailing Address - Country:US
Mailing Address - Phone:512-324-9999
Mailing Address - Fax:999-999-9999
Practice Address - Street 1:1004 W 32ND ST STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1917
Practice Address - Country:US
Practice Address - Phone:512-324-9999
Practice Address - Fax:999-999-9999
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117176364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health