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NPI Code Detail

MEDICARE: KIMBERLY S. PETERS APRN, FNP-BC

MEDICARE: KIMBERLY S. PETERS APRN, FNP-BC
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
1363LF0000XFamily Nurse PractitionerAP143710TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2430817302OTHERTXCSHCN

General Provider Information

NPI Number : 1306485164
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY S. PETERS APRN, FNP-BC
Provider Business Mailing Address
First Line : 6915 WEST AVE
Second Line :
City : CASTLE HILLS
State : TX
Zip : 78213-1822
Country : US
Telephone Number : 210-341-1487
Fax Number :
Provider Business Practice Location Address
First Line : 6915 WEST AVE
Second Line :
City : CASTLE HILLS
State : TX
Zip : 78213-1822
Country : US
Telephone Number : 210-450-9100
Fax Number : 210-450-6009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2019
Last Update Date : 02/15/2023

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