Marvelous Kirven

Individual provider Active NPI Home Health Registered Nurse · Moody, TX

NPI 1982139135 · NPPES record last updated Apr 25, 2017

Key facts

NPI
1982139135
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
782701 (TX)
Practice address
304 Hatter
Moody, TX 76557-4081
Phone
(254) 716-9767
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
782701TXMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 782701 TX
Home Health Registered Nurse 163WH0200X 782701 TX Yes

Addresses

Primary practice location

304 Hatter
Moody, TX 76557-4081

Mailing address

304 Hatter
Moody, TX 76557-4081
Phone (254) 716-9767

Other providers in Moody, TX

All providers in Moody, TX · Home Health Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.