Provider Demographics
NPI:1144537499
Name:KIDWELL, MARNEY B (RN, WHNP)
Entity type:Individual
Prefix:MS
First Name:MARNEY
Middle Name:B
Last Name:KIDWELL
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Gender:F
Credentials:RN, WHNP
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Mailing Address - Street 1:1210 ARION PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2880
Mailing Address - Country:US
Mailing Address - Phone:210-349-9300
Mailing Address - Fax:210-366-2558
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:410
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5405
Practice Address - Country:US
Practice Address - Phone:210-653-5501
Practice Address - Fax:210-646-7752
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2012-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX241726363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health