Healthcare Provider Details

I. General information

NPI: 1265942338
Provider Name (Legal Business Name): KIMBERLEE WILLIAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 W PIONEER PKWY STE K
GRAND PRAIRIE TX
75051-4727
US

IV. Provider business mailing address

3029 MEADOWBROOK DR
GRAND PRAIRIE TX
75052-7548
US

V. Phone/Fax

Practice location:
  • Phone: 945-446-5633
  • Fax:
Mailing address:
  • Phone: 214-870-0844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number821908
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: