Healthcare Provider Details

I. General information

NPI: 1912591082
Provider Name (Legal Business Name): WENDY KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 BROADWAY
SACRAMENTO CA
95820-1527
US

IV. Provider business mailing address

3845 KAPAKA LN
WHEATLAND CA
95692-9488
US

V. Phone/Fax

Practice location:
  • Phone: 916-874-9670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number522206
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: