Healthcare Provider Details

I. General information

NPI: 1801942636
Provider Name (Legal Business Name): DIANE R KUHLMANN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1084 W SAN TAN HILLS
QUEEN CREEK AZ
85243
US

IV. Provider business mailing address

2881 MINERAL PARK RD
QUEEN CREEK AZ
85243
US

V. Phone/Fax

Practice location:
  • Phone: 480-888-7520
  • Fax: 480-655-6137
Mailing address:
  • Phone: 480-888-7520
  • Fax: 480-655-6137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberTLP041825
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: