Provider Demographics
NPI:1689818130
Name:KITE, SANDRA K (RN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:KITE
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 1:8630 SHRUB CT
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-2963
Mailing Address - Country:US
Mailing Address - Phone:907-336-1956
Mailing Address - Fax:
Practice Address - Street 1:8630 SHRUB CT
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2963
Practice Address - Country:US
Practice Address - Phone:907-336-1956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK16301163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse