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General NPI Number Information
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NPI Number | 1982131702
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Entity Type | Individual
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Provider Name | RANDY KAUK NP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 10448 E PENSTAMIN DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-2446
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Country | US
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Telephone | 313-587-7228
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Fax |
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Provider Business Mailing Address
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Address Line | 10448 E PENSTAMIN DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-2446
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Country | US
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Telephone | 313-587-7228
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP11037
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN168849
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License Number State | AZ
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