Provider Demographics
NPI:1669737268
Name:ZAYDEL, KIMBERLY ANN (NP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:ZAYDEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:PRALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-FNP-C
Mailing Address - Street 1:791 ATLANTA ST
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075
Mailing Address - Country:US
Mailing Address - Phone:678-716-7345
Mailing Address - Fax:512-834-4142
Practice Address - Street 1:11350 FOUR POINTS DR #1436
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726
Practice Address - Country:US
Practice Address - Phone:512-834-4141
Practice Address - Fax:512-834-4142
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628430363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily