Healthcare Provider Details

I. General information

NPI: 1972504991
Provider Name (Legal Business Name): LYNN KUHN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR C/O GRANT MEMORIAL HOSPITAL
PETERSBURG WV
26847
US

IV. Provider business mailing address

PO BOX 1019
PETERSBURG WV
26847-1019
US

V. Phone/Fax

Practice location:
  • Phone: 304-257-1026
  • Fax: 304-257-1932
Mailing address:
  • Phone: 304-257-1026
  • Fax: 304-257-1932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number18297
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: