Individual
KIMBERLY DAVIS MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5939 HARRY HINES BOULEVARD 7TH FLOOR SUITE 700, DALLAS, TX 75390-8987
(214) 645-1919
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(617) 633-5555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP140748
TX
363LF0000X
Family Nurse Practitioner
AP140748
TX
Other
Enumeration date
03/23/2019
Last updated
02/08/2021
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