Provider Demographics
NPI:1750658795
Name:SENNET, KIMBERLY FAYE (APN-CNM, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:FAYE
Last Name:SENNET
Suffix:
Gender:F
Credentials:APN-CNM, PMHNP-BC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:FAYE
Other - Last Name:GRAY
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:APN-CNM
Mailing Address - Street 1:214 NORTHERN TRL
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8064
Mailing Address - Country:US
Mailing Address - Phone:702-203-1889
Mailing Address - Fax:
Practice Address - Street 1:1210 COTTONWOOD CREEK TRL STE 230
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2688
Practice Address - Country:US
Practice Address - Phone:512-643-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124363367A00000X
TX1056730363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1750658795Medicaid
TX1056730OtherAPN LICENSE NUMBER
TXAP124363OtherAPN LICENSE NUMBER