Healthcare Provider Details

I. General information

NPI: 1821083536
Provider Name (Legal Business Name): SANDRA KAY KUHN WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4175 S ALAMO AVE BLDG 400
DAVIS MONTHAN AFB AZ
85707
US

IV. Provider business mailing address

4175 S ALAMO AVE BLDG 400
DAVIS MONTHAN AFB AZ
85707
US

V. Phone/Fax

Practice location:
  • Phone: 520-228-2665
  • Fax: 520-228-2185
Mailing address:
  • Phone: 520-228-2665
  • Fax: 520-228-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number520716
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP2950
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: