Provider Demographics
NPI:1114521358
Name:ORTIZ, KATHRYN RAE (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RAE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22118 WOODROSE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2422
Mailing Address - Country:US
Mailing Address - Phone:512-293-4462
Mailing Address - Fax:
Practice Address - Street 1:13201 NW FWY STE 800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6157
Practice Address - Country:US
Practice Address - Phone:512-293-4462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX770994163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal