Kimberly Bridzeke Staton
Nurse Practitioner - Psychiatric/Mental Health
1201 E 7th St Ste 620
Austin
, Texas 78702-3222
Kimberly Bridzeke Staton
Nurse Practitioner - Psychiatric/Mental Health
1201 E 7th St Ste 620
Austin
, Texas 78702-3222
(877) 515-7147
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Kimberly Bridzeke Staton
- 55 Hatchetts Hill Rd
- Old Lyme, CT
- Zip : 06371-1534
- Fax : (877) 515-7147
- Phone : (800) 370-3651
Second Address
- Kimberly Bridzeke Staton
- 1201 E 7th St Ste 620
- Austin, TX
- Zip : 78702-3222
- Fax : (877) 515-7147
- Phone : (800) 370-3651
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP138337 | TX |
National Provider Identifier
| NPI | 1003396391 |
|---|---|
| Provider Name | Kimberly Bridzeke Staton |
| First Address | Old Lyme, CT 06371-1534 |
| Second Address | Austin, TX 78702-3222 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/08/2018 |
| Last Update Date | 16/08/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.