Provider Demographics
NPI:1497808695
Name:UMFRID, KATHY (RN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:UMFRID
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 1:12575 E VIA LINDA
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4310
Mailing Address - Country:US
Mailing Address - Phone:480-484-7011
Mailing Address - Fax:480-484-7001
Practice Address - Street 1:12575 E VIA LINDA
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4310
Practice Address - Country:US
Practice Address - Phone:480-484-7011
Practice Address - Fax:480-484-7001
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN065632163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ626632OtherSCHOOL NURSE