Basic Information
| Provider Information | |||||||||
| NPI: | 1356349617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUHN | ||||||||
| FirstName: | CHARMIN | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8765 LEWIS AVE | ||||||||
| Address2: | |||||||||
| City: | TEMPERANCE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481829583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7348473802 | ||||||||
| FaxNumber: | 7348473418 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | CARLETON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481179461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346542169 | ||||||||
| FaxNumber: | 7346542535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 01/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA9101155 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 1356349617 | 05 | MI | MEDICAID | 291195700 | 05 | FL | MEDICAID | 02214 | 01 | MI | PARAMOUNT | OTHER |