=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063966075
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIZZY PRICE RN, MSN, NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2016
-----------------------------------------------------
Last Update Date | 12/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 407 N CEDAR RIDGE DR STE 210
-----------------------------------------------------
City | DUNCANVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-364-1300
-----------------------------------------------------
Fax | 460-759-6994
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 407 N CEDAR RIDGE DR STE 210
-----------------------------------------------------
City | DUNCANVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75116-3169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-400-2805
-----------------------------------------------------
Fax | 469-759-6994
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | AP131002
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------