Provider Demographics
NPI:1528676400
Name:O'NEAL, KYMBERLY ANETT (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KYMBERLY
Middle Name:ANETT
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 CRYSTAL LN
Mailing Address - Street 2:
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009-7180
Mailing Address - Country:US
Mailing Address - Phone:817-243-4282
Mailing Address - Fax:
Practice Address - Street 1:2900 SE LOOP 820
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-1013
Practice Address - Country:US
Practice Address - Phone:817-922-8182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142813363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health