Healthcare Provider Details

I. General information

NPI: 1871894741
Provider Name (Legal Business Name): MRS. KIMBERLY JANE KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 HOPE ST
ROCKPORT ME
04856-6314
US

IV. Provider business mailing address

85 HOPE ST
ROCKPORT ME
04856-6314
US

V. Phone/Fax

Practice location:
  • Phone: 207-785-2147
  • Fax:
Mailing address:
  • Phone: 207-785-2147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number199390000
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: