Healthcare Provider Details

I. General information

NPI: 1164979035
Provider Name (Legal Business Name): CHRISTINE KUHL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 N MACOMB ST 1A
MONROE MI
48162-3074
US

IV. Provider business mailing address

927 N MACOMB ST 1A
MONROE MI
48162-3074
US

V. Phone/Fax

Practice location:
  • Phone: 812-369-5957
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704322830
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: