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General NPI Number Information
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NPI Number | 1801830674
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Entity Type | Individual
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Provider Name | RITA A KUCMIERZ WHNP
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 3215 W OAK ST
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City | PALESTINE
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State | TX
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Zip | 75801-8484
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Country | US
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Telephone | 903-731-7000
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Fax | 903-731-7016
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Provider Business Mailing Address
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Address Line | PO BOX 145
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City | PALESTINE
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State | TX
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Zip | 75802-0145
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Country | US
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Telephone | 903-731-7000
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Fax | 903-731-7016
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | KUCI-0432-0113
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License Number State | TX
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