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General NPI Number Information
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NPI Number | 1275082679
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Entity Type | Organization
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Legal Business Name | KUINMED LLC
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 6011 CLEVELAND AVE STE B
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City | COLUMBUS
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State | OH
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Zip | 43231-2256
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Country | US
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Telephone | 614-966-1690
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Fax |
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Provider Business Mailing Address
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Address Line | 6011 CLEVELAND AVE STE B
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City | COLUMBUS
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State | OH
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Zip | 43231-2256
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Country | US
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Telephone | 614-966-1690
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. VASTY KLUTSE
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Credential | DNP FNP-C
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Telephone | 405-887-5691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 17118
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License Number State | OH
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