Provider Demographics
NPI:1053794768
Name:MCINTOSH, KAYME (APRN, AGNP-C)
Entity type:Individual
Prefix:
First Name:KAYME
Middle Name:
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-5164
Mailing Address - Country:US
Mailing Address - Phone:817-646-7433
Mailing Address - Fax:817-592-0138
Practice Address - Street 1:107 SW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-5164
Practice Address - Country:US
Practice Address - Phone:817-381-5410
Practice Address - Fax:817-631-0291
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128404363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner