Individual
KIMBERLY WOODS SHIPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 MEMORIAL DRIVE, HUNTSVILLE, TX 77340
(936) 291-4589
Mailing address
PO BOX 9072, HUNTSVILLE, TX 77340-0018
(936) 348-5039
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04565
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA04565
PHYSICIAN ASSISTANT LICEN
TX
Enumeration date
11/25/2005
Last updated
09/08/2009
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