Provider Demographics
NPI:1700678331
Name:WORTHY, KIMBERLY R (HOLISTIC WELLNESS PR)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:R
Last Name:WORTHY
Suffix:
Gender:F
Credentials:HOLISTIC WELLNESS PR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 GUADALUPE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-7114
Mailing Address - Country:US
Mailing Address - Phone:224-419-1823
Mailing Address - Fax:
Practice Address - Street 1:2726 GUADALUPE DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7114
Practice Address - Country:US
Practice Address - Phone:224-419-1823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No172V00000XOther Service ProvidersCommunity Health Worker