Healthcare Provider Details

I. General information

NPI: 1841821790
Provider Name (Legal Business Name): PETE ALLEN KUHN NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12500 WILLOWBROOK RD
CUMBERLAND MD
21502-6393
US

IV. Provider business mailing address

237 GLEASON ST
CUMBERLAND MD
21502-4313
US

V. Phone/Fax

Practice location:
  • Phone: 240-964-1200
  • Fax:
Mailing address:
  • Phone: 301-876-3179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR153233
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: