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General NPI Number Information
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NPI Number | 1669746772
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Entity Type | Individual
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Provider Name | KIMBEREY CALLOWAY REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 5125 WICHITA ST 15283
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City | FORT WORTH
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State | TX
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Zip | 76119-2541
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Country | US
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Telephone | 682-301-2844
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15283
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City | FORT WORTH
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State | TX
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Zip | 76119-0283
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Country | US
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Telephone | 682-301-2844
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 975583
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 975583
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 975583
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 975583
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 975583
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | 975583
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 975583
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License Number State | TX
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