Provider Demographics
NPI:1932208709
Name:BOOKOUT, KIMBERLY R (DNP, RN, CPNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:BOOKOUT
Suffix:
Gender:F
Credentials:DNP, RN, CPNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:4335 WINDSOR CENTRE TRL # 130
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1859
Mailing Address - Country:US
Mailing Address - Phone:214-392-3070
Mailing Address - Fax:
Practice Address - Street 1:4305 WINDSOR CENTRE TRL
Practice Address - Street 2:300
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1864
Practice Address - Country:US
Practice Address - Phone:972-355-7900
Practice Address - Fax:972-355-7922
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX558572363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics