Provider Demographics
NPI:1285721746
Name:KUHN, THOMAS MARK (MSNANP)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:MARK
Last Name:KUHN
Suffix:
Gender:M
Credentials:MSNANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 E LENTZ RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-9528
Mailing Address - Country:US
Mailing Address - Phone:812-333-2437
Mailing Address - Fax:
Practice Address - Street 1:3443 W 3RD ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-4851
Practice Address - Country:US
Practice Address - Phone:812-353-3443
Practice Address - Fax:812-353-3442
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000274A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health