Healthcare Provider Details

I. General information

NPI: 1104283704
Provider Name (Legal Business Name): KURT BUEHRING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 GISHOLT DR STE 111
MONONA WI
53713-4800
US

IV. Provider business mailing address

6400 GISHOLT DR STE 111
MONONA WI
53713-4800
US

V. Phone/Fax

Practice location:
  • Phone: 608-333-0055
  • Fax:
Mailing address:
  • Phone: 608-333-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number88717
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1072-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: