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Individual

CHERYL ANN KITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
691578
TX
363L00000X
Nurse Practitioner
AO1521
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
143581758
MEDICAID
AK
05
144772402
TX
Enumeration date
07/11/2005
Last updated
06/11/2018
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