MEDICARE: KIMBERLY DAKE ALLEMAN 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	163W00000X	Registered Nurse	748543	TX

General Provider Information

NPI Number	:	1912752726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DAKE ALLEMAN RN

Provider Business Mailing Address
First Line	:	6410 FANNIN ST
Second Line	:	STE 810
City	:	HOUSTON
State	:	TX
Zip	:	77030-5201
Country	:	US
Telephone Number	:	936-537-1650
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST STE 810
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-5201
Country	:	US
Telephone Number	:	936-537-1650
Fax Number	:

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

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	04/23/2024

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