Provider Demographics
NPI:1679230023
Name:DUVALL, KAURI
Entity Type:Individual
Prefix:
First Name:KAURI
Middle Name:
Last Name:DUVALL
Suffix:
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 1:625 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:AJO
Mailing Address - State:AZ
Mailing Address - Zip Code:85321-2003
Mailing Address - Country:US
Mailing Address - Phone:520-637-9067
Mailing Address - Fax:
Practice Address - Street 1:625 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:AJO
Practice Address - State:AZ
Practice Address - Zip Code:85321-2003
Practice Address - Country:US
Practice Address - Phone:520-637-9067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health