Individual
MRS. MARISSA ANN KUYKENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
928 N GLENWOOD BLVD, TYLER, TX 75702-5055
(903) 535-9041
Mailing address
5323 HARRY HINES BLVD, DALLAS, TX 75390-9032
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AP143178
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992356588
—
TX
Enumeration date
09/25/2019
Last updated
10/30/2023
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