KIMBERLY DETHEROW (NPI# 1811458094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811458094 |
| Entity Type | Individual |
| Full Name | KIMBERLY DETHEROW |
| Credential | APRN |
| Practice Address |
126 Main Plz San Antonio TX 78205-2745 |
| Mailing Address |
24015 Augusta Falls Ln Spring TX 77389-4276 |
| Practice Telephone | 8883656271 |
| Mailing Telephone | 8322217098 |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP141095 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
126 MAIN PLZ |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78205-2745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043843808 | Tarah Winter Klinefelter | Nurse Practitioner | 126 Main Plz, San Antonio, TX 78205-2745 | 2020-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144862947 | Xeras Medical Technologies, Inc. | Durable Medical Equipment & Medical Supplies | 315 E. Commerce Street Suite 203, San Antonio, TX 78205 | 2019-10-13 |
| 1538631676 | Olga Skirda | Physician Assistant | 610 North Main Avenue, San Antonio, TX 78205 | 2018-12-31 |
| 1508381757 | Davis Vision Inc | Eyewear Supplier (Equipment, not the service) | 175 E Houston, San Antonio, TX 78205 | 2017-08-09 |
| 1841647138 | Karen Tanguma | Counselor | 700 North St. Mary's Street, Suite 1400, San Antonio, TX 78205 | 2016-05-17 |
| 1346652500 | Lone Star Script Care LLC | Case Management | 310 S. S Mary's St, 1290, San Antonio, TX 78205 | 2014-05-22 |
| 1821227919 | Teresa Yanhong Chen | Optometrist | 175 East Houston St, Visionworks, San Antonio, TX 78205 | 2009-07-09 |
| 1164650735 | Mark Joseph Trevino | Ophthalmology | 414 Navarro St Ste 400, San Antonio, TX 78205 | 2009-06-23 |
| 1386882520 | Nicolas A. Melgarejo | Internal Medicine | 343 W. Houston St., Suite #808, San Antonio, TX 78205 | 2009-01-26 |
| 1518135904 | Khan Z Shirani | Emergency Medicine | 414 Navarro St Ste 500, San Antonio, TX 78205 | 2008-02-19 |
| 1619076700 | Candace Lynese Bellamy | Family Medicine | 221 3rd St. West, San Antonio, TX 78205 | 2006-09-22 |
| Find all providers in zip 78205 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659981066 | Gabriel David Alonso | Nurse Practitioner | 12554 Hillside Rnch, San Antonio, TX 78254-6266 | 2020-08-01 |
| 1730685108 | Dimitra Denise Dunlap | Nurse Practitioner | 21827 Barton Woods, San Antonio, TX 78259-2350 | 2018-04-03 |
| 1780186601 | Melissa Ortiz | Nurse Practitioner | 1205 N Loop 1604 W Ste 232, San Antonio, TX 78258-4631 | 2018-03-07 |
| 1659687333 | Robert Chuck Hunt | Nurse Practitioner | 2011 E Houston St Ste 101a, San Antonio, TX 78202-2916 | 2010-08-19 |
| 1124207733 | Diana Lynn Stansbury-bartolomeo | Nurse Practitioner | 1714 Sw Military Dr, San Antonio, TX 78221-1411 | 2007-10-31 |
| 1700912904 | Paula Frances Christianson-silva | Nurse Practitioner | 7703 Floyd Curl Dr Rm 1.422, San Antonio, TX 78229-3901 | 2007-02-24 |
| 1174503742 | Keith Leilan Morgan | Nurse Practitioner | 16302 Ross Oak St, San Antonio, TX 78247-1333 | 2006-01-19 |
| 1841849171 | Linda Esmeralda Gutierrez | Nurse Practitioner | 8401 Datapoint Dr Ste 300, San Antonio, TX 78229-5925 | 2019-09-09 |
| 1164980827 | Daniel Pizana | Nurse Practitioner | 7979 Wurzbach Rd, San Antonio, TX 78229-4427 | 2019-03-12 |
| 1780164814 | Stephanie Buchhorn | Nurse Practitioner | 1642 Lockhill Selma Rd, San Antonio, TX 78213-1929 | 2018-08-17 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78205 |
Please comment or provide details below to improve the information on KIMBERLY DETHEROW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.