MEDICARE: MS. KIMBERLY A DUNN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	625184	TX

General Provider Information

NPI Number	:	1497230411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY A DUNN RN

Provider Business Mailing Address
First Line	:	2206 FALKIRK DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2611
Country	:	US
Telephone Number	:	512-554-4184
Fax Number	:

Provider Business Practice Location Address
First Line	:	2206 FALKIRK DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681
Country	:	US
Telephone Number	:	512-554-4184
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	09/25/2018

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