Provider Demographics
NPI:1730703414
Name:MUNOZ, KIMBERLY MICHELE (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MICHELE
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 EASY ST
Mailing Address - Street 2:
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009-6000
Mailing Address - Country:US
Mailing Address - Phone:817-823-3946
Mailing Address - Fax:
Practice Address - Street 1:3808 EASY ST
Practice Address - Street 2:
Practice Address - City:ALVARADO
Practice Address - State:TX
Practice Address - Zip Code:76009-6000
Practice Address - Country:US
Practice Address - Phone:817-823-3946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX893581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse