Individual provider · Type 1 NPI
Kimberly Detherow, APRN
Adult Health Nurse Practitioner · San Antonio, TX
NPI number
1811458094
Active
Practice location
126 Main Plz
San Antonio, TX 78205-2745
Mailing address
24015 Augusta Falls Ln
Spring, TX 77389-4276
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | AP141095 (TX) |
Adult Health Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1811458094
Kimberly Detherow, APRN's National Provider Identifier is 1811458094, issued on Mar 28, 2019. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in San Antonio, TX. The record was last updated on Mar 28, 2019.