Provider Demographics
NPI:1972119766
Name:KUEHHAS, LAUREN JESSICA
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JESSICA
Last Name:KUEHHAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:WEISE KUEHHAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:5917 CROSSTOWN EXPY
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78417-3504
Mailing Address - Country:US
Mailing Address - Phone:361-854-0811
Mailing Address - Fax:
Practice Address - Street 1:613 ELIZABETH ST STE 804
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2231
Practice Address - Country:US
Practice Address - Phone:361-902-4343
Practice Address - Fax:361-902-6000
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61075174363A00000X
TXPA16036363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant