Provider Demographics
NPI:1649845066
Name:KUHLENBECK, BRITTANY KAY (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KAY
Last Name:KUHLENBECK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4657 N 700 E
Mailing Address - Street 2:
Mailing Address - City:CRAIGVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46731-9730
Mailing Address - Country:US
Mailing Address - Phone:260-246-8503
Mailing Address - Fax:
Practice Address - Street 1:105 HILLCREST DRIVE
Practice Address - Street 2:
Practice Address - City:OSSIAN
Practice Address - State:IN
Practice Address - Zip Code:46777-9053
Practice Address - Country:US
Practice Address - Phone:260-622-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10003261A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant