Provider Demographics
NPI:1477716900
Name:KUEHNLE, LAURA DIAZ (VA,DC,ANCC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:DIAZ
Last Name:KUEHNLE
Suffix:
Gender:F
Credentials:VA,DC,ANCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7103 LATOUR CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-3958
Mailing Address - Country:US
Mailing Address - Phone:703-203-7910
Mailing Address - Fax:
Practice Address - Street 1:7103 LATOUR CT
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-3958
Practice Address - Country:US
Practice Address - Phone:703-203-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARN0001109325163W00000X
DCRN53582363LA2200X
VANP0024109325363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse