Individual
KIMBERLY CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4710 PEACHTREE ST, GRANBURY, TX 76048-4401
(817) 771-1905
Mailing address
4710 PEACHTREE ST, GRANBURY, TX 76048-4401
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
349829
TX
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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