Healthcare Provider Details

I. General information

NPI: 1831691179
Provider Name (Legal Business Name): KRISTA LEE ANN KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 DOE MEADOW DR
AUSTIN TX
78749-2866
US

IV. Provider business mailing address

8111 DOE MEADOW DR
AUSTIN TX
78749-2866
US

V. Phone/Fax

Practice location:
  • Phone: 512-650-7404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number106968
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: