Basic Information
| Provider Information | |||||||||
| NPI: | 1497784557 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINKNEY | ||||||||
| FirstName: | KERRIE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5219 CITY BANK PKWY STE 35 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067610333 | ||||||||
| FaxNumber: | 8067820097 | ||||||||
| Practice Location | |||||||||
| Address1: | 602 INDIANA AVENUE | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067758200 | ||||||||
| FaxNumber: | 8067759182 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2006 | ||||||||
| LastUpdateDate: | 01/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LC0200X | K2259 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 208000000X | MD421619 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | MD421619 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 208D00000X | MD421619 | PA | N | Allopathic & Osteopathic Physicians | General Practice | 208M00000X | MD421619 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 001726583 | 05 | PA | MEDICAID |