MEDICARE: MARYKUTTY FRANCIS PMHNP, FNP-BC

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	363LF0000X	Family Nurse Practitioner	AP136919	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP136919	TX

General Provider Information

NPI Number	:	1538653944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYKUTTY FRANCIS PMHNP, FNP-BC

Provider Business Mailing Address
First Line	:	308 S FRIENDSWOOD DR STE 200
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-3989
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:	281-648-2200

Provider Business Practice Location Address
First Line	:	4825 ALLIANCE BLVD STE 150
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-5504
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:	281-648-2200

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

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	04/26/2023

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