Provider Demographics
NPI:1023873197
Name:KINGSTON, NISHA GAIL DENISE
Entity type:Individual
Prefix:MS
First Name:NISHA
Middle Name:GAIL DENISE
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6318 LUCE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-5810
Mailing Address - Country:US
Mailing Address - Phone:281-900-8084
Mailing Address - Fax:
Practice Address - Street 1:6318 LUCE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-5810
Practice Address - Country:US
Practice Address - Phone:281-900-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator