Provider Demographics
NPI:1962898205
Name:THURMAN, KAELA (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:KAELA
Middle Name:
Last Name:THURMAN
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 W SH29 SUITE 5
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642
Mailing Address - Country:US
Mailing Address - Phone:512-548-5373
Mailing Address - Fax:512-548-5374
Practice Address - Street 1:12701 W SH29 SUITE 5
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642
Practice Address - Country:US
Practice Address - Phone:512-548-5373
Practice Address - Fax:512-548-5374
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX755568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily