Provider Demographics
NPI:1205205234
Name:KUCHINSKY, DAWN MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:KUCHINSKY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 GUILFORD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-1312
Mailing Address - Country:US
Mailing Address - Phone:215-431-7091
Mailing Address - Fax:
Practice Address - Street 1:268 GUILFORD RD
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-1312
Practice Address - Country:US
Practice Address - Phone:215-431-7091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014788363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner