Individual
MRS. KIMBERLY KATHERYNE MIKLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP, NNP
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246-2017
(214) 820-0111
Mailing address
2235 WATERROCK DR, ALLEN, TX 75013-5361
(214) 383-2947
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
AP116494
TX
363LN0005X
Critical Care Neonatal Nurse Practitioner
693590
TX
363LP0200X
Pediatric Nurse Practitioner
693590
TX
363LP2300X
Primary Care Nurse Practitioner
693590
TX
Other
Enumeration date
12/20/2007
Last updated
08/10/2022
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