Individual
KIMBERLY STAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6719 TRINITY TRAIL LN, RICHMOND, TX 77469-1952
(314) 546-5955
Mailing address
6215 WAYNE WAY, ROSENBERG, TX 77471-1911
(314) 546-5955
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
2001005289
MO
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
TX
Enumeration date
08/13/2018
Last updated
08/30/2019
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