Provider Demographics
NPI:1235569146
Name:CUTTS, KRISTINE VIVIAN (RN)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:VIVIAN
Last Name:CUTTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 TRAILWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4934
Mailing Address - Country:US
Mailing Address - Phone:214-403-2530
Mailing Address - Fax:
Practice Address - Street 1:110 TRAILWOOD DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4934
Practice Address - Country:US
Practice Address - Phone:214-403-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606193163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606193OtherTEXAS NURSING COMPACT LICENSE