Individual
SUZAN DIANE KITCHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
419 N JACKSON AVE, ODESSA, TX 79761-5124
(806) 715-7290
Mailing address
2516 59TH ST, LUBBOCK, TX 79413-5638
(806) 715-7290
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
807095
TX
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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