Provider Demographics
NPI:1558916320
Name:KAIHURA, ALPHONCINA JOHN SR
Entity Type:Individual
Prefix:
First Name:ALPHONCINA
Middle Name:JOHN
Last Name:KAIHURA
Suffix:SR
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 1:155 MAPLE ST STE 207
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105-1828
Mailing Address - Country:US
Mailing Address - Phone:413-285-8722
Mailing Address - Fax:413-285-8642
Practice Address - Street 1:155 MAPLE ST STE 207
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-1828
Practice Address - Country:US
Practice Address - Phone:413-285-8722
Practice Address - Fax:413-285-8642
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2331939163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice