Provider Demographics
NPI:1982185807
Name:PIKUDA, MOSUNMOLA FEYISETAN (RN)
Entity type:Individual
Prefix:MRS
First Name:MOSUNMOLA
Middle Name:FEYISETAN
Last Name:PIKUDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 WEST BELLFORT STREET
Mailing Address - Street 2:APT 48
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031
Mailing Address - Country:US
Mailing Address - Phone:832-475-8799
Mailing Address - Fax:
Practice Address - Street 1:9200 WEST BELLFORT STREET
Practice Address - Street 2:APT 48
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031
Practice Address - Country:US
Practice Address - Phone:832-475-8799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX766171163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty