Provider Demographics
NPI:1336257203
Name:KUEHN, REBECCA R (PA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:R
Last Name:KUEHN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2027
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52244-2027
Mailing Address - Country:US
Mailing Address - Phone:319-339-3855
Mailing Address - Fax:319-358-2791
Practice Address - Street 1:503 3RD ST
Practice Address - Street 2:
Practice Address - City:KALONA
Practice Address - State:IA
Practice Address - Zip Code:52247-9526
Practice Address - Country:US
Practice Address - Phone:319-656-3151
Practice Address - Fax:319-656-3319
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001082363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA080137367OtherRAILROAD MEDICARE
IA621305OtherUHC OF THE RIVER VALLEY
IA46068OtherWELLMARK BCBS
IAS60371Medicare UPIN
IA621305OtherUHC OF THE RIVER VALLEY
IA46068Medicare PIN
IA080137367OtherRAILROAD MEDICARE