Healthcare Provider Details

I. General information

NPI: 1982110912
Provider Name (Legal Business Name): JENNIFER LYNN KUHN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 MYRTLE ST STE 160
ERIE PA
16502-4602
US

IV. Provider business mailing address

2315 MYRTLE ST STE 160
ERIE PA
16502-4602
US

V. Phone/Fax

Practice location:
  • Phone: 814-456-9197
  • Fax: 814-455-2765
Mailing address:
  • Phone: 814-456-9197
  • Fax: 814-455-2765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018113
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: