Healthcare Provider Details

I. General information

NPI: 1053980664
Provider Name (Legal Business Name): LEAH NICOLE KUHLENSCHMIDT PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 09/27/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MULBERRY ST
EVANSVILLE IN
47713-1230
US

IV. Provider business mailing address

10314 CHATTERIS RD
EVANSVILLE IN
47725-8175
US

V. Phone/Fax

Practice location:
  • Phone: 812-423-7791
  • Fax:
Mailing address:
  • Phone: 812-306-7408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71011231A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: