Provider Demographics
NPI:1760812242
Name:GATLIN, KIMBERLY JUNE X (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JUNE
Last Name:GATLIN
Suffix:X
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 COLORADO BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6812
Mailing Address - Country:US
Mailing Address - Phone:940-484-1887
Mailing Address - Fax:940-591-0458
Practice Address - Street 1:3303 COLORADO BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6812
Practice Address - Country:US
Practice Address - Phone:940-484-1887
Practice Address - Fax:940-591-0458
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily