Healthcare Provider Details

I. General information

NPI: 1235568932
Provider Name (Legal Business Name): CASSANDRA LYNN KUHL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13315 W CENTER RD
OMAHA NE
68144-3449
US

IV. Provider business mailing address

PO BOX 642117
OMAHA NE
68164-8117
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-9400
  • Fax: 402-717-9401
Mailing address:
  • Phone: 402-398-6254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number111600
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: