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General NPI Number Information
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NPI Number | 1730957937
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Entity Type | Individual
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Provider Name | MERCY TATANG KUJA NP
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Gender | Female
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 2600 W PLEASANT RUN RD
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City | LANCASTER
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State | TX
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Zip | 75146-1114
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Country | US
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Telephone | 972-948-2851
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 W PLEASANT RUN RD
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City | LANCASTER
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State | TX
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Zip | 75146-1114
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Country | US
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Telephone | 469-297-5401
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1135289
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License Number State | TX
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