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General NPI Number Information
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NPI Number | 1558966036
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Entity Type | Individual
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Provider Name | KAMI STUCKEY CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 2801 NW 79TH AVE
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City | MIAMI
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State | FL
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Zip | 33122-1174
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Country | US
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Telephone | 786-466-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2520 NW 84TH AVE APT 301
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City | DORAL
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State | FL
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Zip | 33122-1541
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Country | US
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Telephone | 786-857-7124
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9403034
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 132139
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License Number State | FL
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