MEDICARE: KIMBERLY SHERIE MATTHEW

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	163W00000X	Registered Nurse	754337-01	NY
2	163W00000X	Registered Nurse	1082835	TX

General Provider Information

NPI Number	:	1942096383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY SHERIE MATTHEW

Provider Business Mailing Address
First Line	:	9606 TORRINGTON
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5026
Country	:	US
Telephone Number	:	404-775-2218
Fax Number	:

Provider Business Practice Location Address
First Line	:	9606 TORRINGTON
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5026
Country	:	US
Telephone Number	:	404-775-2218
Fax Number	:

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

Provider Enumeration Date	:	04/15/2025
Last Update Date	:	04/15/2025

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Directions to “ KIMBERLY SHERIE MATTHEW ” Practice Location

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