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Individual
DR. KEVIN LEE LETZ
Active
Individual
DR. KEVIN LEE LETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP17933
CA
363LF0000X
Family Nurse Practitioner
71000749A
IN
363LF0000X
Family Nurse Practitioner
AP3102
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11059766
CAQH
—
05
—
200229520
—
IN
01
—
500029255
RAILROAD MEDICARE
—
Enumeration date
04/06/2006
Last updated
04/08/2010
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