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General NPI Number Information
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NPI Number | 1982024766
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Entity Type | Organization
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Legal Business Name | CLINICAL BRIDGES PLLC
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 5527 FM 636
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City | KERENS
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State | TX
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Zip | 75144-4001
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Country | US
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Telephone | 817-687-9138
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Fax | 817-549-0094
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Provider Business Mailing Address
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Address Line | 8841 HIDDEN HILL DR
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City | FORT WORTH
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State | TX
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Zip | 76179-2917
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Country | US
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Telephone | 817-897-7412
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL/OWNER
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Name | KIMBERLY JOYCE NELSON
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Credential | N.P.
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Telephone | 817-897-7412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 632193
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License Number State | TX
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