Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | AP130557 | TX |
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP130557 | TX |
NPI | 1053772053 |
---|---|
Provider Name | Kim Andrews |
First Address | Dallas, TX 75373-3784 |
Second Address | Mckinney, TX 75071-7665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2016 |
Last Update Date | 18/05/2021 |