Provider Demographics
NPI:1518978857
Name:KIDD, NANCY N (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:N
Last Name:KIDD
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 1:7200 WYOMING SPGS STE 300
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4304
Mailing Address - Country:US
Mailing Address - Phone:512-244-3755
Mailing Address - Fax:512-244-9318
Practice Address - Street 1:7200 WYOMING SPGS
Practice Address - Street 2:SUITE 300
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4303
Practice Address - Country:US
Practice Address - Phone:512-244-3755
Practice Address - Fax:512-244-9318
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX236907163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery