Provider Demographics
NPI:1649622770
Name:DAYAL, KIMBERLEE (NP)
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:
Last Name:DAYAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 GUADALUPE ST
Mailing Address - Street 2:STE. 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-2908
Mailing Address - Country:US
Mailing Address - Phone:512-476-2830
Mailing Address - Fax:512-476-2832
Practice Address - Street 1:4611 GUADALUPE ST
Practice Address - Street 2:STE. 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-2908
Practice Address - Country:US
Practice Address - Phone:512-476-2830
Practice Address - Fax:512-476-2832
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX813349163W00000X
TXF0616974363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse