Provider Demographics
NPI:1336568443
Name:STUENKEL, KATHRYN J (MD)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:J
Last Name:STUENKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:MSC 09 5040
Mailing Address - Street 2:UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-6607
Mailing Address - Fax:
Practice Address - Street 1:MSC 09 5040
Practice Address - Street 2:UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6607
Practice Address - Fax:505-272-8045
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMRS2014-0320390200000X
NMMD2017-0296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program