Provider Demographics
NPI:1619452455
Name:KAUSHAL, KATI JO (DNP)
Entity type:Individual
Prefix:DR
First Name:KATI
Middle Name:JO
Last Name:KAUSHAL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 ALTHEA ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-4254
Mailing Address - Country:US
Mailing Address - Phone:651-216-6491
Mailing Address - Fax:
Practice Address - Street 1:1720 FM 544 STE 100
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-4592
Practice Address - Country:US
Practice Address - Phone:651-216-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6215363LF0000X
MN2015174363LF0000X
TX1055555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily