Provider Demographics
NPI:1124176300
Name:KUHN, KIMBERLY M (DOM)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:KUHN
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4163 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-1101
Mailing Address - Country:US
Mailing Address - Phone:727-710-4798
Mailing Address - Fax:831-621-4820
Practice Address - Street 1:4163 1ST AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1101
Practice Address - Country:US
Practice Address - Phone:727-710-4798
Practice Address - Fax:831-621-4820
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046961041C0700X
MD131381041C0700X
CA271461041C0700X
FLAP3850171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical