Individual
SANDRA ANITA KAVULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4936 DEERWOOD AVE, YOUNGSTOWN, FL 32466-2028
(406) 338-6369
Mailing address
760 HOSPITAL CIRCLE, BROWNING, MT 59417-0760
(406) 338-6369
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9164999
FL
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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