Provider Demographics
NPI:1477210599
Name:STRICKLAND, KIMBERLY DIANE (NP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DIANE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 BIRDSONG CT
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-6258
Mailing Address - Country:US
Mailing Address - Phone:254-644-7573
Mailing Address - Fax:
Practice Address - Street 1:2801 GATEWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2694
Practice Address - Country:US
Practice Address - Phone:844-388-6541
Practice Address - Fax:844-452-8151
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059243363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology