MEDICARE: MRS. KATE NWIKE FNP

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	363L00000X	Nurse Practitioner	2011020281	TX

General Provider Information

NPI Number	:	1548607146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATE NWIKE FNP

Provider Business Mailing Address
First Line	:	3628 REDSTART DR
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-4300
Country	:	US
Telephone Number	:	917-497-7595
Fax Number	:

Provider Business Practice Location Address
First Line	:	3628 REDSTART DR
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-4300
Country	:	US
Telephone Number	:	214-647-1551
Fax Number	:

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

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	05/23/2013

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