Healthcare Provider Details

I. General information

NPI: 1285083337
Provider Name (Legal Business Name): BRETT KUHN MPAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 MCNEEL LN
NORTH PLATTE NE
69101-6054
US

IV. Provider business mailing address

22201 N 148TH ST
GREENWOOD NE
68366-9621
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-6655
  • Fax:
Mailing address:
  • Phone: 308-293-4081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number2015
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: