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Individual

MRS. KIM RENAE MOWERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MS, CPNP

Contact information

Practice address
760 N DENTON TAP RD, SUITE 130, COPPELL, TX 75019-2163
(972) 420-1475
(214) 222-2435
Mailing address
PO BOX 2429, COPPELL, TX 75019-8429
(972) 420-1475
(214) 222-2435

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
660006
TX

Other

Enumeration date
08/15/2005
Last updated
04/16/2010
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