Provider Demographics
NPI:1013640929
Name:KUCH, DAWN ALICIA
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ALICIA
Last Name:KUCH
Suffix:
Gender:F
Credentials:
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 565
Mailing Address - Street 2:
Mailing Address - City:BUIES CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27506-0565
Mailing Address - Country:US
Mailing Address - Phone:910-893-1560
Mailing Address - Fax:
Practice Address - Street 1:129 T T LANIER STREET
Practice Address - Street 2:
Practice Address - City:BUIES CREEK
Practice Address - State:NC
Practice Address - Zip Code:27506
Practice Address - Country:US
Practice Address - Phone:910-893-1560
Practice Address - Fax:910-814-5727
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator