# MRS. KAE M SUKUT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1578518916
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 427 | MT | Yes |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 02/03/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1578518916 | — | MT |
| 01 | — | 97363 | BLUE CROSS/BLUE SHIELD | MT |
| 01 | — | DG9848 | MEDICARE RAILROAD GROUP NUMBER | — |
| 01 | — | POO475855 | MEDICARE RAILROAD PTAN | — |