Provider Demographics
NPI:1184676561
Name:SARNA, KRISTINE KENSCHE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:KENSCHE
Last Name:SARNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 W WHISPERING WIND DR
Mailing Address - Street 2:STE 173
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-2867
Mailing Address - Country:US
Mailing Address - Phone:623-565-5060
Mailing Address - Fax:623-565-5061
Practice Address - Street 1:2060 W WHISPERING WIND DR
Practice Address - Street 2:STE 173
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-2867
Practice Address - Country:US
Practice Address - Phone:623-565-5060
Practice Address - Fax:623-565-5061
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H32367Medicare UPIN