MEDICARE: PAMELA JOYCE KUHLMANN RN, BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	220489-3102	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	U002	OTHER	UT	DESERET MUTUAL
2	U006	OTHER	UT	INTERMOUTAIN HEALTH CARE

General Provider Information

NPI Number	:	1174509277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA JOYCE KUHLMANN RN, BSN

Provider Business Mailing Address
First Line	:	1608 WYNGATE PARK DR
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-8418
Country	:	US
Telephone Number	:	801-553-9798
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 S MAIN ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-3176
Country	:	US
Telephone Number	:	801-539-7000
Fax Number	:	801-539-7050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	07/08/2007

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