MEDICARE: KIMBERLY RANEE EAST FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1000031	TX

General Provider Information

NPI Number	:	1235727876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY RANEE EAST FNP

Provider Business Mailing Address
First Line	:	6743 MEMORIAL DR
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79606-2558
Country	:	US
Telephone Number	:	325-231-4667
Fax Number	:	325-231-4668

Provider Business Practice Location Address
First Line	:	6743 MEMORIAL DR
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79606-2558
Country	:	US
Telephone Number	:	325-231-4667
Fax Number	:	325-231-4668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2021
Last Update Date	:	01/20/2026

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