Healthcare Provider Details

I. General information

NPI: 1437168242
Provider Name (Legal Business Name): VICKIE ANN KUHN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 W JEFFERSON ST
WAXAHACHIE TX
75165-2231
US

IV. Provider business mailing address

125 YOUNGBLOOD RD
WAXAHACHIE TX
75165-8708
US

V. Phone/Fax

Practice location:
  • Phone: 972-923-7178
  • Fax:
Mailing address:
  • Phone: 817-300-5305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number509918
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: