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NPI Code Detail

MEDICARE: KIMBERLY MICHELLE BLUM APRN, AGCNS

MEDICARE:   KIMBERLY MICHELLE BLUM  APRN, AGCNS
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
1364SA2200XAdult Health Clinical Nurse SpecialistAP126079TX

Other Identifiers

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

General Provider Information

NPI Number : 1376952457
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY MICHELLE BLUM APRN, AGCNS
Provider Business Mailing Address
First Line : 7951 SHOAL CREEK BLVD STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78757-7582
Country : US
Telephone Number : 512-584-8404
Fax Number : 737-377-0442
Provider Business Practice Location Address
First Line : 1706 HIGHWAY 1431
Second Line :
City : MARBLE FALLS
State : TX
Zip : 78654-4954
Country : US
Telephone Number : 512-834-4141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2014
Last Update Date : 11/24/2025

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Directions to “ KIMBERLY MICHELLE BLUM APRN, AGCNS” Practice Location

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