MEDICARE: MS. ANDREA MARIE KALUZA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	728841	TX
2	163WA2000X	Administrator Registered Nurse	728841	TX
3	163WC0400X	Case Management Registered Nurse	728841	TX
4	163WP2201X	Ambulatory Care Registered Nurse	728841	TX
5	163WW0101X	Ambulatory Women's Health Care Registered Nurse	728841	TX

General Provider Information

NPI Number	:	1346282647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA MARIE KALUZA RN

Provider Business Mailing Address
First Line	:	36000 DARNALL LOOP
Second Line	:	CARL R DARNALL ARMY MEDICAL CENTER
City	:	FORT HOOD
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:	254-553-3141
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLDG 94043
Second Line	:	WEST FORT HOOD CLINIC
City	:	FORT HOOD
State	:	TX
Zip	:	76544-4752
Country	:	US
Telephone Number	:	254-553-3141
Fax Number	:	254-285-6193

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	01/08/2013

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