Healthcare Provider Details

I. General information

NPI: 1740790864
Provider Name (Legal Business Name): BREANNE NICOLE KUHN ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N DALE MABRY HWY STE 100
TAMPA FL
33609-2764
US

IV. Provider business mailing address

10901 BRIGHTON BAY BLVD NE APT 1202
ST PETERSBURG FL
33716-3447
US

V. Phone/Fax

Practice location:
  • Phone: 813-289-2500
  • Fax:
Mailing address:
  • Phone: 618-363-7028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9461135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: