Healthcare Provider Details

I. General information

NPI: 1659657815
Provider Name (Legal Business Name): CHARLEENE LEWIS KUHN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S. LINCOLN AVE VA MEDICAL CENTER
LEBANON PA
17042-9970
US

IV. Provider business mailing address

1700 S. LINCOLN AVE
LEBANON PA
17042-9970
US

V. Phone/Fax

Practice location:
  • Phone: 717-272-6621
  • Fax:
Mailing address:
  • Phone: 717-272-6621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA00739
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: