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General NPI Number Information
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NPI Number | 1831469006
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Entity Type | Individual
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Provider Name | LOUISE M. CUPIT L.V.N.
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Gender | Female
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 1101 S MAIN ST ROOM 1600
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City | FORT WORTH
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State | TX
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Zip | 76104-4802
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Country | US
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Telephone | 817-321-4952
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Fax | 817-850-8511
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Provider Business Mailing Address
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Address Line | 1101 S. MAIN STREET ROOM 1600
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City | FORT WORTH
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State | TX
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Zip | 76104
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Country | US
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Telephone | 817-321-4952
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Fax | 817-850-8511
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 90072
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License Number State | TX
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