Provider Demographics
NPI:1811318009
Name:HA, KIMBERLY (FNP)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43 YU DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2458
Mailing Address - Country:US
Mailing Address - Phone:830-608-9300
Mailing Address - Fax:830-626-1727
Practice Address - Street 1:43 YU DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2458
Practice Address - Country:US
Practice Address - Phone:830-608-9300
Practice Address - Fax:830-626-1727
Is Sole Proprietor?:No
Enumeration Date:2013-12-15
Last Update Date:2013-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX688062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily