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NPI Code Detail

MEDICARE: KIMBERLY DEESE MSN, RN, CPNP-AC

MEDICARE: KIMBERLY DEESE MSN, RN, CPNP-AC
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
1363LP0222XCritical Care Pediatric Nurse PractitionerAP139496TX

General Provider Information

NPI Number : 1588121008
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY DEESE MSN, RN, CPNP-AC
Provider Business Mailing Address
First Line : 6431 FANNIN STE
Second Line : MSB2.130B
City : HOUSTON
State : TX
Zip : 77030-1501
Country : US
Telephone Number : 713-500-7700
Fax Number :
Provider Business Practice Location Address
First Line : 6411 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-1501
Country : US
Telephone Number : 713-500-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2019
Last Update Date : 09/23/2022

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