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1003396391
KIMBERLY BRIDZEKE STATON
AUSTIN, TX
NPI
1003396391
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX AP138337)
Enumeration Date
2018-08-16
Last Update Date
2018-08-16
Business Address
KIMBERLY BRIDZEKE STATON APRN
1201 E 7TH ST STE 620
AUSTIN, TX 78702-3222
Phone number: 800-370-3651
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Mailing Address
KIMBERLY BRIDZEKE STATON APRN
55 HATCHETTS HILL RD
OLD LYME, CT 06371-1534
Phone number: 800-370-3651
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