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General NPI Number Information
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NPI Number | 1497269013
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Entity Type | Organization
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Legal Business Name | RK FIRST ASSIST, PLLC
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Dates
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Enumeration Date | 11/17/2017
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Last Update Date | 11/17/2017
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Provider Practice Location Address
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Address Line | 4705 SHAWNEE TRL
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City | AMARILLO
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State | TX
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Zip | 79109-5937
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Country | US
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Telephone | 806-676-0810
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3353
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City | AMARILLO
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State | TX
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Zip | 79116-3353
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Country | US
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Telephone | 806-676-0810
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Fax |
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Authorized Official
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Title or Position | FNP-BC
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Name | RENEA KRTALIC
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Credential |
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Telephone | 806-676-0810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP129163
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License Number State | TX
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