MEDICARE: MRS. KIMBERLY NICHOLE SCOTT 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	AP144657	TX

General Provider Information

NPI Number	:	1336779941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY NICHOLE SCOTT FNP

Provider Business Mailing Address
First Line	:	201 SOUTHVIEW DR
Second Line	:
City	:	HUDSON OAKS
State	:	TX
Zip	:	76087-8232
Country	:	US
Telephone Number	:	863-528-5627
Fax Number	:

Provider Business Practice Location Address
First Line	:	1508 SANTA FE DR STE 103
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5859
Country	:	US
Telephone Number	:	817-242-5789
Fax Number	:	888-752-9156

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

Provider Enumeration Date	:	01/22/2020
Last Update Date	:	11/21/2025

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