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General NPI Number Information
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NPI Number | 1366443434
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Entity Type | Individual
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Provider Name | EDWARD JOHN KUHNLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 05/05/2024
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Provider Practice Location Address
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Address Line | 3345 N WINDSONG DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2283
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Country | US
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Telephone | 928-445-5211
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Fax |
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Provider Business Mailing Address
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Address Line | 103 RUM RUNNER WAY
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City | ST JOHNS
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State | FL
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Zip | 32259-2267
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Country | US
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Telephone | 434-316-4646
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 21761
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 0101029164
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License Number State | VA
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