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General NPI Number Information
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NPI Number | 1215634639
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Entity Type | Individual
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Provider Name | KIM MARIE MAY
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Gender | Female
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 4055 VALLEY VIEW LN
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City | DALLAS
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State | TX
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Zip | 75244-5074
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Country | US
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Telephone | 469-712-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 309 ARKANSAS AVE
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-2165
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Country | US
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Telephone | 870-706-9576
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 213403
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License Number State | AR
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