Healthcare Provider Details

I. General information

NPI: 1831093020
Provider Name (Legal Business Name): KATHRYN GRACE IRVIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PINE ST
ABILENE TX
79601-2432
US

IV. Provider business mailing address

1118 S LA SALLE DR
ABILENE TX
79605-3612
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1040174
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: