Individual
KIMBERLY MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1341 W MOCKINGBIRD LN STE 600W, DALLAS, TX 75247-6904
(832) 856-3376
Mailing address
235 WHITSONS RUN, STAFFORD, VA 22554-1717
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP1028864
DC
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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