MEDICARE: MRS. KIMBERLY FAYE SENNET APN-CNM, PMHNP-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
1	367A00000X	Advanced Practice Midwife	AP124363	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1056730	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1056730	OTHER	TX	APN LICENSE NUMBER
3	AP124363	OTHER	TX	APN LICENSE NUMBER

General Provider Information

NPI Number	:	1750658795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY FAYE SENNET APN-CNM, PMHNP-BC

Provider Business Mailing Address
First Line	:	214 NORTHERN TRL
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-8064
Country	:	US
Telephone Number	:	702-203-1889
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 COTTONWOOD CREEK TRL STE 230
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-2688
Country	:	US
Telephone Number	:	512-643-6099
Fax Number	:

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

Provider Enumeration Date	:	11/18/2011
Last Update Date	:	02/18/2022

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