Individual
KIMBERLY JOYCE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5527 FM 636, KERENS, TX 75144-4001
(817) 473-0546
Mailing address
8841 HIDDEN HILL DR, FORT WORTH, TX 76179-2917
(817) 473-0546
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
632193
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168683401
—
TX
05
—
168683405
—
TX
05
—
168683406
—
TX
01
—
8N7755
BCBS
TX
Enumeration date
09/20/2006
Last updated
10/10/2024
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