Provider Demographics
NPI:1497139109
Name:MCNUTT, KIMBERLEY (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:
Last Name:MCNUTT
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 COIT RD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0500
Mailing Address - Country:US
Mailing Address - Phone:214-472-8100
Mailing Address - Fax:214-472-8140
Practice Address - Street 1:4401 COIT RD
Practice Address - Street 2:SUITE 407
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0500
Practice Address - Country:US
Practice Address - Phone:214-472-8100
Practice Address - Fax:214-472-8140
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578839163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant