Healthcare Provider Details

I. General information

NPI: 1386842573
Provider Name (Legal Business Name): STEPHEN BARR KUHLMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S 23RD ST
FORT PIERCE FL
34950-4803
US

IV. Provider business mailing address

2995 SE ASTER LN APT. F203
STUART FL
34994-5705
US

V. Phone/Fax

Practice location:
  • Phone: 772-461-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN155457
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9286059
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: