Healthcare Provider Details

I. General information

NPI: 1215234752
Provider Name (Legal Business Name): SUSAN JO KUHN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8414 NAAB RD
INDIANAPOLIS IN
46260-1972
US

IV. Provider business mailing address

8414 NAAB RD
INDIANAPOLIS IN
46260-1972
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-7510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number28075275A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number71003550A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: