Provider Demographics
NPI:1174002893
Name:MENISSY, KATRINA N (FAMILY NURSE PRACTIT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:N
Last Name:MENISSY
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:NAFFIA
Other - Last Name:BALSHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18310 W AIRPORT BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407
Mailing Address - Country:US
Mailing Address - Phone:832-756-7772
Mailing Address - Fax:832-730-4481
Practice Address - Street 1:18310 W AIRPORT BLVD
Practice Address - Street 2:STE 100
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407
Practice Address - Country:US
Practice Address - Phone:832-756-7772
Practice Address - Fax:832-730-4481
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily