=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255654315
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. JANICE KUHN, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2010
-----------------------------------------------------
Last Update Date | 03/03/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11635 ARBOR ST SUITE 110
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68144-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-885-7811
-----------------------------------------------------
Fax | 402-884-1145
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11635 ARBOR ST SUITE 110
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68144-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-885-7811
-----------------------------------------------------
Fax | 402-884-1145
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER OPERATOR
-----------------------------------------------------
Name | JANICE KAY CAUDILL-KUHN
-----------------------------------------------------
Credential | APRN, PHD
-----------------------------------------------------
Telephone | 402-885-7811
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 110513
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------