Provider Demographics
NPI:1770886178
Name:HAM, KITTY WOO (RN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:KITTY WOO
Middle Name:
Last Name:HAM
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:KITTY
Other - Middle Name:
Other - Last Name:WOO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12221 RENFERT WAY
Mailing Address - Street 2:STE 110
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5658
Mailing Address - Country:US
Mailing Address - Phone:512-596-1424
Mailing Address - Fax:512-601-0333
Practice Address - Street 1:12221 RENFERT WAY STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758
Practice Address - Country:US
Practice Address - Phone:512-601-0303
Practice Address - Fax:512-601-0333
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX720653363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner