Provider Demographics
NPI:1134415631
Name:RABAGOS, KATHERINE C (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:C
Last Name:RABAGOS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E CAESAR AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-6322
Mailing Address - Country:US
Mailing Address - Phone:361-516-0800
Mailing Address - Fax:361-516-0855
Practice Address - Street 1:500 E CAESAR AVE
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-6322
Practice Address - Country:US
Practice Address - Phone:361-516-0800
Practice Address - Fax:361-516-0855
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX660986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily