Basic Information
Provider Information
NPI: 1285128413
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUHN
FirstName: CHEYENNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PMHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MARKUS
OtherFirstName: CHEYENNE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 711 BARNES AVE
Address2:  
City: LA JUNTA
State: CO
PostalCode: 810502138
CountryCode: US
TelephoneNumber: 8005115446
FaxNumber: 7193845672
Practice Location
Address1: 711 BARNES AVE
Address2:  
City: LA JUNTA
State: CO
PostalCode: 810502138
CountryCode: US
TelephoneNumber: 8005115446
FaxNumber: 7193845672
Other Information
ProviderEnumerationDate: 06/20/2018
LastUpdateDate: 10/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN.1655212CON Nursing Service ProvidersRegistered Nurse 
163WP0808X1655212CON Nursing Service ProvidersRegistered NursePsych/Mental Health
363LP0808XAPN.0998137-NPCOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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