Provider Demographics
NPI:1205135688
Name:KINMAN, KAREN (PHD, RN, LMFT)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:KINMAN
Suffix:
Gender:F
Credentials:PHD, RN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76095-0375
Mailing Address - Country:US
Mailing Address - Phone:682-552-6191
Mailing Address - Fax:
Practice Address - Street 1:1109 CHEEK SPARGER RD STE 100
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-4199
Practice Address - Country:US
Practice Address - Phone:682-552-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605692163W00000X
TX201604106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163W00000XNursing Service ProvidersRegistered Nurse