Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | AP60411115 | WA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP60411115 | WA |
NPI | 1285063644 |
---|---|
Provider Name | Katie Marie Kasunick |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane Valley, WA 99216-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2013 |
Last Update Date | 20/05/2021 |