Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP124059 | TX |
NPI | 1003062928 |
---|---|
Provider Name | Ms. Kimberley Shenee Player |
First Address | Tampa, FL 33614-7163 |
Second Address | Dallas, TX 75243-7148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2008 |
Last Update Date | 12/04/2020 |