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Individual
KIMBERLY FUGMAN BYRUM
Active
Individual
KIMBERLY FUGMAN BYRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
669375
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003162454
BLUE CROSS BLUE SHIELD
TX
05
—
305066802
—
TX
05
—
305066803
—
TX
01
—
8365ND
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/02/2012
Last updated
12/17/2013
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