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General NPI Number Information
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NPI Number | 1124774500
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Entity Type | Individual
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Provider Name | IESHIA KIMBLE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 1005 W RALPH HALL PKWY
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City | ROCKWALL
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State | TX
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Zip | 75032-6658
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Country | US
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Telephone | 469-545-0160
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Fax | 469-589-4976
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Provider Business Mailing Address
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Address Line | 6114 GULLY GROVE DR
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City | ROYSE CITY
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State | TX
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Zip | 75189-3161
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Country | US
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Telephone | 414-520-7156
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Fax | 469-589-4976
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1071306
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License Number State | TX
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