Individual
EDWARD JOHN KUHNLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3345 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-2283
(928) 445-5211
Mailing address
103 RUM RUNNER WAY, ST JOHNS, FL 32259-2267
(434) 316-4646
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
21761
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
0101029164
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010220742
—
VA
01
—
186465
ANTHEM PROVIDER NUMBER
—
01
—
20-3639329
PCHP PROVIDER NUMBER
—
01
—
203639329001
TRICARE PROVIDER NUMBER
—
01
—
204775
VALUE OPTIONS PROVIDER NU
—
01
—
2120869
CIGNA BEHAVIOR PROVIDER N
—
01
—
O85925
SENTARA PROVIDER NUMBER
—
Enumeration date
08/10/2005
Last updated
05/05/2024
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