Provider Demographics
NPI:1548412356
Name:ECKHARDT, KARI JILL (RNC WHNP CNM)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:JILL
Last Name:ECKHARDT
Suffix:
Gender:F
Credentials:RNC WHNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SCHOOL ST
Mailing Address - Street 2:SUITE 29
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4595
Mailing Address - Country:US
Mailing Address - Phone:281-374-1860
Mailing Address - Fax:281-255-0550
Practice Address - Street 1:455 SCHOOL ST
Practice Address - Street 2:SUITE 29
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4595
Practice Address - Country:US
Practice Address - Phone:281-374-1860
Practice Address - Fax:281-255-0550
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX680133363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207741401Medicaid
TX207741401Medicaid