Healthcare Provider Details

I. General information

NPI: 1013840206
Provider Name (Legal Business Name): MRS. KIMBERLY RANKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3136 HORIZON RD STE 100
ROCKWALL TX
75032-7808
US

IV. Provider business mailing address

3136 HORIZON RD STE 100
ROCKWALL TX
75032-7808
US

V. Phone/Fax

Practice location:
  • Phone: 972-475-8914
  • Fax: 855-364-4959
Mailing address:
  • Phone: 972-475-8914
  • Fax: 855-364-4959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1247920
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number157618
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: