Provider Demographics
NPI:1871789909
Name:KINCAID, KATHERINE JANETTE (LVN)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:JANETTE
Last Name:KINCAID
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7314 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-2051
Mailing Address - Country:US
Mailing Address - Phone:214-288-4211
Mailing Address - Fax:972-412-7679
Practice Address - Street 1:7314 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-2051
Practice Address - Country:US
Practice Address - Phone:214-288-4211
Practice Address - Fax:972-412-7679
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82013164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82013OtherLVN