Provider Demographics
NPI:1013787191
Name:KITOKO, CREE
Entity Type:Individual
Prefix:
First Name:CREE
Middle Name:
Last Name:KITOKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 SOUTHERN BELLE DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5937
Mailing Address - Country:US
Mailing Address - Phone:254-338-2007
Mailing Address - Fax:
Practice Address - Street 1:5701 SOUTHERN BELLE DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5937
Practice Address - Country:US
Practice Address - Phone:254-338-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula