Provider Demographics
NPI:1306029129
Name:KUHN, JILL A (PHD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:A
Last Name:KUHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270674
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80527-0674
Mailing Address - Country:US
Mailing Address - Phone:970-219-9206
Mailing Address - Fax:
Practice Address - Street 1:323 W DRAKE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-8115
Practice Address - Country:US
Practice Address - Phone:970-219-9206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO59823020Medicaid
CO59823020Medicaid