Provider Demographics
NPI:1902860786
Name:JONES, KIMBERLY KAREN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:KAREN
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 DIAMOND LOCH W
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8729
Mailing Address - Country:US
Mailing Address - Phone:817-771-5906
Mailing Address - Fax:
Practice Address - Street 1:3801 DIAMOND LOCH W
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8729
Practice Address - Country:US
Practice Address - Phone:817-771-5906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693365367500000X
MO2010019830367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85140UOtherBCBS
TX157295003Medicaid
TX157295004Medicaid
TX8G2672Medicare ID - Type Unspecified
TX85140UOtherBCBS
TX157295004Medicaid