Healthcare Provider Details

I. General information

NPI: 1366884264
Provider Name (Legal Business Name): JODEE JEAN KUHL B.S.N., R.N., M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5228 W. FONDULAC AVE
MILWAUKEE WI
53216-1346
US

IV. Provider business mailing address

1717 W LAWN AVE
MILWAUKEE WI
53209-5136
US

V. Phone/Fax

Practice location:
  • Phone: 414-871-9111
  • Fax:
Mailing address:
  • Phone: 414-351-9909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number106052
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: