Healthcare Provider Details

I. General information

NPI: 1861317265
Provider Name (Legal Business Name): KIMBERLY NICOLE STEPHENS CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 CAT HOLLOW DR STE 104
ROUND ROCK TX
78681-5797
US

IV. Provider business mailing address

7700 CAT HOLLOW DR STE 104
ROUND ROCK TX
78681-5797
US

V. Phone/Fax

Practice location:
  • Phone: 512-733-5437
  • Fax:
Mailing address:
  • Phone: 512-733-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1228701
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: