1699732842 NPI number — MISS EVELYN LEONIE KUIDA R.N. C.O.H.N-S

Table of content: MISS EVELYN LEONIE KUIDA R.N. C.O.H.N-S (NPI 1699732842)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699732842 NPI number — MISS EVELYN LEONIE KUIDA R.N. C.O.H.N-S

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
KUIDA

Provider First Name:
EVELYN

Provider Middle Name:
LEONIE

Provider Name Prefix Text:
MISS

Provider Name Suffix Text:

Provider Credential Text:
R.N. C.O.H.N-S

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:
KUIDA

Provider Other First Name:
EVELYN

Provider Other Middle Name:
LEONIE

Provider Other Name Prefix Text:
MS.

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699732842

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
07/08/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12234 E CAMINO LOMA VIS

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:
YUMA

Provider Business Mailing Address State Name:
AZ

Provider Business Mailing Address Postal Code:
85367-7348

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
928-329-1050

Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 C ST

Provider Second Line Business Practice Location Address:
USA YUMA PROVING GROUND HEALTH CLINIC BDG 990

Provider Business Practice Location Address City Name:
YUMA

Provider Business Practice Location Address State Name:
AZ

Provider Business Practice Location Address Postal Code:
85365-9498

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
928-328-3206

Provider Business Practice Location Address Fax Number:
928-328-3197

Provider Enumeration Date:
04/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

Provider Taxonomy Codes

Taxonomy code: 163WX0106X , with the licence number: 235172 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .