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General NPI Number Information
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NPI Number | 1770034720
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Entity Type | Individual
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Provider Name | KIMBERLY CEDILLO APRN, FNP-C,PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1305 W ILLINOIS AVE
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City | MIDLAND
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State | TX
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Zip | 79701-6159
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Country | US
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Telephone | 432-303-4673
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Fax | 432-303-4674
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Provider Business Mailing Address
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Address Line | 1305 W ILLINOIS AVE
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City | MIDLAND
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State | TX
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Zip | 79701-6159
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Country | US
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Telephone | 432-303-4673
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Fax | 432-303-4674
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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 | AP132212
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP132212
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License Number State | TX
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