Healthcare Provider Details

I. General information

NPI: 1154765675
Provider Name (Legal Business Name): DOROTHY PEGGIE KUHNS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4951 OAKLAND DRIVE
LYNDHURST OH
44124
US

IV. Provider business mailing address

4951 OAKLAND DRIVE
LYNDHURST OH
44124
US

V. Phone/Fax

Practice location:
  • Phone: 216-381-0789
  • Fax: 216-274-9002
Mailing address:
  • Phone: 216-381-0789
  • Fax: 216-274-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number097518
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: