Doctor Name: | BRANDY KOTZ |
NPI Number: | 1114312576 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | AP127360 |
Business Practice Address: | 3600 Gates Blvd Emergency Room Port Arthur, TX - 776423858 |
Business Phone Number: | 4099895124 |
Business Fax Number: | |
Mailing Address: | 213 Gage Ave, NEDERLAND |
State: | TX |
Postal Code: | 776272100 |
Phone Number: | 4097198895 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2015 |
NPI Last Update Date: | 04/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP127360 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |