Provider Demographics
NPI:1962989327
Name:KALU, SUNSHINE LEMMY
Entity type:Individual
Prefix:
First Name:SUNSHINE
Middle Name:LEMMY
Last Name:KALU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4085 N BELT LINE RD APT 2004
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-8527
Mailing Address - Country:US
Mailing Address - Phone:214-636-8332
Mailing Address - Fax:
Practice Address - Street 1:4085 N BELT LINE RD APT 2004
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-8527
Practice Address - Country:US
Practice Address - Phone:214-636-8332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX947417163W00000X
WI149529367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse