Healthcare Provider Details

I. General information

NPI: 1295243368
Provider Name (Legal Business Name): KIMBERLY SUE KUHLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 ELMWOOD AVE
ROCHESTER NY
14620-9797
US

IV. Provider business mailing address

1111 ELMWOOD AVE
ROCHESTER NY
14620-3005
US

V. Phone/Fax

Practice location:
  • Phone: 585-241-1626
  • Fax:
Mailing address:
  • Phone: 585-241-1626
  • Fax: 585-241-1233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number472746
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number472746
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: