Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 598693 | CA |
NPI | 1043364896 |
---|---|
Provider Name | Kendra Rea Budka |
First Address | Whittier, CA 90601-3847 |
Second Address | Whittier, CA 90601-3941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/07/2007 |