Healthcare Provider Details

I. General information

NPI: 1205294345
Provider Name (Legal Business Name): WILLIAM KEVIN VILLANUEVA KUHN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 SCARBOROUGH DR STE 100
COLORADO SPRINGS CO
80920-7518
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-955-4200
  • Fax: 719-365-7667
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1995
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0005667
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: