Provider Demographics
NPI:1780210310
Name:VOSSAH, KIMBERLY RACHEL (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RACHEL
Last Name:VOSSAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 TERMINI ST UNIT 1120
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-0749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6919 OVERTON ST
Practice Address - Street 2:
Practice Address - City:HITCHCOCK
Practice Address - State:TX
Practice Address - Zip Code:77563-7756
Practice Address - Country:US
Practice Address - Phone:832-564-9859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570911163WH0200X
TX911570163WH0200X
TX7135911163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health