Healthcare Provider Details

I. General information

NPI: 1568778223
Provider Name (Legal Business Name): CHRISTINE M KUTZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTY KUTZ FNP

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N THOMPSON ST
CONROE TX
77301-2541
US

IV. Provider business mailing address

521 N THOMPSON ST
CONROE TX
77301-2541
US

V. Phone/Fax

Practice location:
  • Phone: 936-538-3779
  • Fax: 936-538-3787
Mailing address:
  • Phone: 936-538-3779
  • Fax: 936-538-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number618299
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number618299
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: