Provider Demographics
NPI:1750107207
Name:CHATMAN-SPELL, KIMBERLY (MSN,RN,CCRN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:CHATMAN-SPELL
Suffix:
Gender:F
Credentials:MSN,RN,CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17611 BIG OAKS GRV
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8568
Mailing Address - Country:US
Mailing Address - Phone:832-512-5123
Mailing Address - Fax:
Practice Address - Street 1:17611 BIG OAKS GRV
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8568
Practice Address - Country:US
Practice Address - Phone:832-512-5123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347C00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle