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General NPI Number Information
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NPI Number | 1720440092
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Entity Type | Individual
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Provider Name | RHODA KUTESA BICKERSTAFF NP
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Gender | Female
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1505 W JEFFERSON ST STE 155
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City | WAXAHACHIE
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State | TX
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Zip | 75165-2223
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Country | US
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Telephone | 469-550-2031
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Fax | 469-550-2039
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Provider Business Mailing Address
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Address Line | 1505 W JEFFERSON ST STE 155
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City | WAXAHACHIE
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State | TX
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Zip | 75165-2223
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Country | US
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Telephone | 469-550-2031
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Fax | 469-550-2039
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | AP130637
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | AP130637
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP130637
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License Number State | TX
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