Basic Information
| Provider Information | |||||||||
| NPI: | 1336568443 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STUENKEL | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | MSC 09 5040 | ||||||||
| Address2: | UNIVERSITY OF NEW MEXICO | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052726607 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | MSC 09 5040 | ||||||||
| Address2: | UNIVERSITY OF NEW MEXICO | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052726607 | ||||||||
| FaxNumber: | 5052728045 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2014 | ||||||||
| LastUpdateDate: | 10/18/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | RS2014-0320 | NM | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | MD2017-0296 | NM | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.