Provider Demographics
NPI:1235892019
Name:KITUTU, AIKANDE (RN)
Entity Type:Individual
Prefix:
First Name:AIKANDE
Middle Name:
Last Name:KITUTU
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 1:14911 WOOD SWALLOW WAY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6571
Mailing Address - Country:US
Mailing Address - Phone:832-512-1219
Mailing Address - Fax:
Practice Address - Street 1:14911 WOOD SWALLOW WAY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6571
Practice Address - Country:US
Practice Address - Phone:832-512-1219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX768169163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care