MEDICARE: MRS. KIM PATRICIA MIHELICH F.N.P.-C

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	363LF0000X	Family Nurse Practitioner	250339	TX

General Provider Information

NPI Number	:	1912997958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIM PATRICIA MIHELICH F.N.P.-C

Provider Business Mailing Address
First Line	:	1441 N BECKLEY AVE
Second Line	:	5TH FLOOR
City	:	DALLAS
State	:	TX
Zip	:	75203-1201
Country	:	US
Telephone Number	:	214-947-1837
Fax Number	:	214-947-1851

Provider Business Practice Location Address
First Line	:	1441 N BECKLEY AVE
Second Line	:	5TH FLOOR
City	:	DALLAS
State	:	TX
Zip	:	75203-1201
Country	:	US
Telephone Number	:	214-947-1837
Fax Number	:	214-947-1851

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/08/2007

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