Healthcare Provider Details

I. General information

NPI: 1235569146
Provider Name (Legal Business Name): KRISTINE VIVIAN CUTTS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 TRAILWOOD DR
ALLEN TX
75002-4934
US

IV. Provider business mailing address

110 TRAILWOOD DR
ALLEN TX
75002-4934
US

V. Phone/Fax

Practice location:
  • Phone: 214-403-2530
  • Fax:
Mailing address:
  • Phone: 214-403-2530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number606193
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: