Healthcare Provider Details

I. General information

NPI: 1265828172
Provider Name (Legal Business Name): KATHRYN MARY KUEHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 BREMO RD
RICHMOND VA
23226-1900
US

IV. Provider business mailing address

5801 BREMO RD
RICHMOND VA
23226-1907
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-2011
  • Fax: 713-500-5805
Mailing address:
  • Phone: 804-287-7113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0101272012
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: