Provider Demographics
NPI:1932102472
Name:SANDERS, KURT (CRNFA)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:
Last Name:SANDERS
Suffix:
Gender:M
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6555
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85261-6555
Mailing Address - Country:US
Mailing Address - Phone:480-945-3125
Mailing Address - Fax:480-947-4543
Practice Address - Street 1:11022 E REGAL DR
Practice Address - Street 2:
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-7918
Practice Address - Country:US
Practice Address - Phone:480-945-3125
Practice Address - Fax:480-947-4543
Is Sole Proprietor?:No
Enumeration Date:2005-05-28
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN063926163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ368812OtherAHCCS PIN