Provider Demographics
NPI:1144231564
Name:JONES, KIMBERA MILLS (NP)
Entity type:Individual
Prefix:DR
First Name:KIMBERA
Middle Name:MILLS
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 POST OAK LN
Mailing Address - Street 2:
Mailing Address - City:RIESEL
Mailing Address - State:TX
Mailing Address - Zip Code:76682-3421
Mailing Address - Country:US
Mailing Address - Phone:806-363-0256
Mailing Address - Fax:
Practice Address - Street 1:1301 W GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1135
Practice Address - Country:US
Practice Address - Phone:806-363-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP107690363LA2100X
TX571387363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care