Provider Demographics
NPI:1649224585
Name:KUEHNLENZ, DIANE RUTH (RN, APN, CCNS)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:RUTH
Last Name:KUEHNLENZ
Suffix:
Gender:F
Credentials:RN, APN, CCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18981 US HIGHWAY 441 STE 121
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6735
Mailing Address - Country:US
Mailing Address - Phone:352-633-9858
Mailing Address - Fax:352-633-9870
Practice Address - Street 1:8550 NE 138TH LN BLDG 800
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-633-9858
Practice Address - Fax:352-633-9870
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004793364S00000X, 364SM0705X
FLAPRN9368172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical