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Individual

KATHLEEN DEVERA TEMBROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AC-CPNP, MSN, CCRN

Contact information

Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 740-6177
Mailing address
3455 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-3076

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
201709498RN
OR
363L00000X
Nurse Practitioner
Primary
1021237
TX

Other

Enumeration date
09/03/2019
Last updated
01/24/2022
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