Provider Demographics
NPI:1568778223
Name:KUTZ, CHRISTINE M (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:KUTZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:KUTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:521 N THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-2541
Mailing Address - Country:US
Mailing Address - Phone:936-538-3779
Mailing Address - Fax:936-538-3787
Practice Address - Street 1:521 N THOMPSON ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2541
Practice Address - Country:US
Practice Address - Phone:936-538-3779
Practice Address - Fax:936-538-3787
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX618299363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily