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General NPI Number Information
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NPI Number | 1477191476
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Entity Type | Individual
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Provider Name | STEPHANIE N KINGMAN FNP
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Gender | Female
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 3533 S ALAMEDA ST
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-1721
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Country | US
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Telephone | 361-694-5900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4190
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-4190
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Country | US
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Telephone | 304-908-9202
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Fax | 304-399-2526
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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 | 1151583
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License Number State | TX
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