Individual
REBECCA KUDLATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 BECKNER RD STE 1600, SANTA FE, NM 87507-3641
(505) 772-2000
Mailing address
6621 FANNIN ST # MCW1998, HOUSTON, TX 77030-2358
(832) 828-3660
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1077309
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
77787
NM
Other
Enumeration date
06/28/2022
Last updated
04/23/2024
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