Individual
MONA KIDWELL
Active
Individual
MONA KIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
508280
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2035487-02
—
TX
05
—
3031130-01
—
TX
01
—
88N956
BCBS
TX
01
—
P01095012
RAIL ROAD MEDICARE
TX
Enumeration date
06/04/2012
Last updated
06/07/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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