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General NPI Number Information
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NPI Number | 1568839512
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Entity Type | Individual
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Provider Name | KAY BODUDE MSN, BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2015
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 321 W HATCHER RD STE 206
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City | PHOENIX
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State | AZ
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Zip | 85021-2493
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Country | US
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Telephone | 602-675-1686
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Fax | 602-675-1703
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Provider Business Mailing Address
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Address Line | 7067 W JACKRABBIT LN
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City | PEORIA
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State | AZ
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Zip | 85383-6018
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Country | US
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Telephone | 602-675-1686
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Fax | 602-675-1703
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 11-3766310
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License Number State | AZ
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