Provider Demographics
NPI:1134401078
Name:KUHNS, SHELLY L (APRN-FPA, CCNS)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:L
Last Name:KUHNS
Suffix:
Gender:F
Credentials:APRN-FPA, CCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 W FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-2334
Mailing Address - Country:US
Mailing Address - Phone:217-722-1896
Mailing Address - Fax:833-933-0632
Practice Address - Street 1:602 W FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2334
Practice Address - Country:US
Practice Address - Phone:217-722-1896
Practice Address - Fax:833-933-0632
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277-000198364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208905161Medicare PIN