Individual
DIANA MARIE MIKULENCAK-PICHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1110 N SARAH DEWITT DR, GONZALES, TX 78629-3311
(830) 672-8502
Mailing address
1430 N AVENUE B, SHINER, TX 77984-6220
(361) 401-1344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
830443
TX
363L00000X
Nurse Practitioner
Primary
AP136271
TX
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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