Healthcare Provider Details

I. General information

NPI: 1659819803
Provider Name (Legal Business Name): REBECCA KUHN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2017
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 E SPRING ST
LONG BEACH CA
90815-1554
US

IV. Provider business mailing address

3845 COLLEGE AVE
CULVER CITY CA
90232-3602
US

V. Phone/Fax

Practice location:
  • Phone: 562-421-4791
  • Fax:
Mailing address:
  • Phone: 423-667-8794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: