Healthcare Provider Details

I. General information

NPI: 1790837078
Provider Name (Legal Business Name): JANICE KAY CAUDILL-KUHN APRN, PHD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 S 40TH ST STE 320
LINCOLN NE
68506-5248
US

IV. Provider business mailing address

19330 PACIFIC ST
ELKHORN NE
68022-2718
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-5765
  • Fax:
Mailing address:
  • Phone: 402-289-3247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberMC0833120
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: