Provider Demographics
NPI:1508180142
Name:SUKEL, KATHY LYNN
Entity Type:Individual
Prefix:MISS
First Name:KATHY
Middle Name:LYNN
Last Name:SUKEL
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 1:614 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3674
Mailing Address - Country:US
Mailing Address - Phone:704-636-2900
Mailing Address - Fax:704-636-2800
Practice Address - Street 1:614 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3674
Practice Address - Country:US
Practice Address - Phone:704-636-2900
Practice Address - Fax:704-636-2800
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC69359164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse