Provider Demographics
NPI:1275082679
Name:KUINMED LLC
Entity Type:Organization
Organization Name:KUINMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VASTY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLUTSE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP-C
Authorized Official - Phone:405-887-5691
Mailing Address - Street 1:6011 CLEVELAND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2256
Mailing Address - Country:US
Mailing Address - Phone:614-966-1690
Mailing Address - Fax:
Practice Address - Street 1:6011 CLEVELAND AVE STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2256
Practice Address - Country:US
Practice Address - Phone:614-966-1690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty