Individual
KIMBERLY BRIDZEKE STATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1201 E 7TH ST STE 620, AUSTIN, TX 78702-3222
(800) 370-3651
(877) 515-7147
Mailing address
55 HATCHETTS HILL RD, OLD LYME, CT 06371-1534
(800) 370-3651
(877) 515-7147
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP138337
TX
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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