Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | LJ0000146 | DE |
N | 363LP0200X | Nurse Practitioner - Pediatrics | LJ0000146 | DE |
NPI | 1043302888 |
---|---|
Provider Name | Ms. Wendla P. Kutz |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 23/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4001974 | (05) | MD |
8973407 | (05) | NJ |
P68894 | (02) |