Individual
KATHERINE WIED KYROUAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
413 US HIGHWAY 87, COMFORT, TX 78013-3845
(318) 366-3863
Mailing address
413 US HIGHWAY 87, COMFORT, TX 78013-3845
(318) 366-3863
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1089381
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
1089381
TX
Other
Enumeration date
08/12/2022
Last updated
12/27/2023
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