Provider Demographics
NPI:1811433055
Name:KUHL, STACY ANNE (NP - BC)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:ANNE
Last Name:KUHL
Suffix:
Gender:F
Credentials:NP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-3447
Mailing Address - Country:US
Mailing Address - Phone:619-993-8996
Mailing Address - Fax:
Practice Address - Street 1:1580 N 2ND ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-3447
Practice Address - Country:US
Practice Address - Phone:619-993-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004992363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95004992OtherCALIFORNIA BOARD OF REGISTERED NURSING