Healthcare Provider Details

I. General information

NPI: 1780797274
Provider Name (Legal Business Name): CAMILLE R KUHNLEY ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 DIPLOMACY DR
ANCHORAGE AK
99508-5925
US

IV. Provider business mailing address

4320 DIPLOMACY DR
ANCHORAGE AK
99508-5925
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-3100
  • Fax: 907-729-3170
Mailing address:
  • Phone: 907-729-3100
  • Fax: 907-729-3170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number192
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: