Kidwell, Mona

Kidwell, Mona is an sole proprietor health care provider with primary practice located at 2785 Gulf Fwy S Suite 115, League City TX 77573-4979. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Kidwell, Mona can be contacted via phone (832) 816-1370.

Contact Information

Primary practice address
2785 Gulf Fwy S Suite 115 League City TX 77573-4979
Phone: (832) 816-1370
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 508280 Texas

Profile Details

NPI number 1043571243
LBN Legal business name Kidwell, Mona
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 4th, 2012
Last updated Jun 7th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043571243 NPPES
Texas Other 88N956 BCBS
Texas MEDICAID 3031130-01 BCBS
Texas MEDICAID 2035487-02 BCBS
Texas Other P01095012 BCBS

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