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General NPI Number Information
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NPI Number | 1568188605
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Entity Type | Individual
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Provider Name | KIMBERLY CLEMENS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 15101 W FM 2147
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City | HORSESHOE BAY
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State | TX
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Zip | 78657-2168
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Country | US
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Telephone | 830-262-0988
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Fax |
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Provider Business Mailing Address
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Address Line | 3917 LAKEVIEW DR
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City | COTTONWOOD SHORES
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State | TX
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Zip | 78657-9463
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Country | US
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Telephone | 512-968-2903
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1103901
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License Number State | TX
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