Healthcare Provider Details

I. General information

NPI: 1710713474
Provider Name (Legal Business Name): TREVOR KUEHN CPNP-AC/PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 W FAIDLEY AVE
GRAND ISLAND NE
68803-4109
US

IV. Provider business mailing address

1504 WARBLER CIR
GRAND ISLAND NE
68803-3933
US

V. Phone/Fax

Practice location:
  • Phone: 308-675-3171
  • Fax:
Mailing address:
  • Phone: 308-830-9427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number115614
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: