Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 98002 | TX |
NPI | 1063625952 |
---|---|
Provider Name | Mrs. Bonnie Lynn Kitchen |
First Address | North Richland Hills, TX 76180-6558 |
Second Address | Hurst, TX 76054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |