Provider Demographics
NPI:1124744131
Name:CLINKENBEARD, KIMBERLY NORA-BETH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:NORA-BETH
Last Name:CLINKENBEARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 NORTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-5114
Mailing Address - Country:US
Mailing Address - Phone:281-306-8501
Mailing Address - Fax:281-360-8617
Practice Address - Street 1:3036 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5114
Practice Address - Country:US
Practice Address - Phone:281-360-8501
Practice Address - Fax:281-360-8617
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-12
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1096548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily