Provider Demographics
NPI:1215716386
Name:FOX, KYMBERLY BROOKE (MSN, APRN, CNM)
Entity type:Individual
Prefix:
First Name:KYMBERLY
Middle Name:BROOKE
Last Name:FOX
Suffix:
Gender:F
Credentials:MSN, APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76501-3159
Mailing Address - Country:US
Mailing Address - Phone:254-563-6255
Mailing Address - Fax:
Practice Address - Street 1:720 N 3RD ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-3159
Practice Address - Country:US
Practice Address - Phone:254-563-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX946206163WM0102X
TX1140978363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn