Provider Demographics
NPI:1023598380
Name:MCDOWELL, KIMBERLY FELICIA
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:FELICIA
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 CAMILLA RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-8132
Mailing Address - Country:US
Mailing Address - Phone:254-371-6488
Mailing Address - Fax:
Practice Address - Street 1:5701 WESTCLIFF RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-8807
Practice Address - Country:US
Practice Address - Phone:254-289-4707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX197078164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse