Provider Demographics
NPI:1568839512
Name:BODUDE, KAY (MSN, BSN, RN)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:BODUDE
Suffix:
Gender:F
Credentials:MSN, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7067 W JACKRABBIT LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-6018
Mailing Address - Country:US
Mailing Address - Phone:602-675-1686
Mailing Address - Fax:602-675-1703
Practice Address - Street 1:321 W HATCHER RD STE 206
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2493
Practice Address - Country:US
Practice Address - Phone:602-675-1686
Practice Address - Fax:602-675-1703
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11-3766310163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health