Individual
KIM HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4140 MCKNIGHT RD, TEXARKANA, TX 75503-0921
(855) 498-6767
(479) 968-1673
Mailing address
170 TRAILS END, WASKOM, TX 75692-5642
(902) 926-9647
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1134762
TX
Other
Enumeration date
08/21/2023
Last updated
11/13/2024
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