Provider Demographics
NPI:1992369599
Name:KITHCART, ABBY
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:KITHCART
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 1:10231 GRACIE LN
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-5401
Mailing Address - Country:US
Mailing Address - Phone:713-252-4332
Mailing Address - Fax:
Practice Address - Street 1:10231 GRACIE LN
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-5401
Practice Address - Country:US
Practice Address - Phone:713-252-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305784164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse