Provider Demographics
NPI:1679538458
Name:KUEHN, ERIN COLLEEN (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:COLLEEN
Last Name:KUEHN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 S KELLER PARK DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-8547
Mailing Address - Country:US
Mailing Address - Phone:920-735-6674
Mailing Address - Fax:
Practice Address - Street 1:815 S KELLER PARK DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-8547
Practice Address - Country:US
Practice Address - Phone:920-735-6674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38300300Medicaid