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NPI Code Detail

MEDICARE: KATHRYN SULKOWSKI MD

MEDICARE: KATHRYN SULKOWSKI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician21922NV

General Provider Information

NPI Number : 1649737388
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN SULKOWSKI MD
Provider Business Mailing Address
First Line : 4700 LAS VEGAS BLVD N
Second Line :
City : LAS VEGAS
State : NV
Zip : 89191-6600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4700 LAS VEGAS BLVD N
Second Line :
City : NELLIS AFB
State : NV
Zip : 89191-6600
Country : US
Telephone Number : 702-653-3445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2019
Last Update Date : 02/02/2026

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