Provider Demographics
NPI:1902382369
Name:KULAPA, HUBERTINE KOKO
Entity Type:Individual
Prefix:
First Name:HUBERTINE
Middle Name:KOKO
Last Name:KULAPA
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 1:1325 DAJA LN APT 2104
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-7653
Mailing Address - Country:US
Mailing Address - Phone:817-495-2902
Mailing Address - Fax:
Practice Address - Street 1:1325 DAJA LN APT 2104
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-7653
Practice Address - Country:US
Practice Address - Phone:817-495-2902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313955164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse