Healthcare Provider Details

I. General information

NPI: 1588916076
Provider Name (Legal Business Name): PETER JEREMY KUHNS PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 10/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 CRUTCHFIELD ST
DURHAM NC
27704-2754
US

IV. Provider business mailing address

309 CRUTCHFIELD STREET
DURHAM NC
27704
US

V. Phone/Fax

Practice location:
  • Phone: 919-923-7666
  • Fax:
Mailing address:
  • Phone: 919-923-7666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3113
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: