Provider Demographics
NPI:1598940488
Name:BIEVER, KIMBERLIE A (ANP-BC, CCNS)
Entity Type:Individual
Prefix:
First Name:KIMBERLIE
Middle Name:A
Last Name:BIEVER
Suffix:
Gender:F
Credentials:ANP-BC, CCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 STANLEY RD STE 121
Mailing Address - Street 2:
Mailing Address - City:JBSA FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-2715
Mailing Address - Country:US
Mailing Address - Phone:210-295-2568
Mailing Address - Fax:210-295-2749
Practice Address - Street 1:2981 GARDEN AVE
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-7635
Practice Address - Country:US
Practice Address - Phone:210-916-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX962898163WC0200X
VA0024164612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine