Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 648305 | TX |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 648305 | TX |
NPI | 1356303465 |
---|---|
Provider Name | Mrs. Kimberley Michelle Drum |
First Address | Richardson, TX 75082-3542 |
Second Address | Dallas, TX 75246-2017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 16/11/2016 |