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General NPI Number Information
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NPI Number | 1063413557
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Entity Type | Individual
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Provider Name | KIMBERLY ANN SHAFER R.N., F.N.P.-B.C.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 2601 WASSON RD
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City | BIG SPRING
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State | TX
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Zip | 79720-6416
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Country | US
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Telephone | 432-714-4284
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Fax | 432-714-4286
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Provider Business Mailing Address
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Address Line | 2601 WASSON RD
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City | BIG SPRING
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State | TX
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Zip | 79720-6416
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Country | US
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Telephone | 432-714-4284
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Fax | 432-714-4286
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 578393
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License Number State | TX
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