Provider Demographics
NPI:1225585318
Name:MKULISI, NOSISA
Entity Type:Individual
Prefix:
First Name:NOSISA
Middle Name:
Last Name:MKULISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15335 PARK ROW
Mailing Address - Street 2:APT 803
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2891
Mailing Address - Country:US
Mailing Address - Phone:918-282-6846
Mailing Address - Fax:
Practice Address - Street 1:15335 PARK ROW
Practice Address - Street 2:APT 803
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2891
Practice Address - Country:US
Practice Address - Phone:918-282-6846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other