Provider Demographics
NPI:1083413835
Name:KUNTZ, JODY LYNN (NREMT)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:LYNN
Last Name:KUNTZ
Suffix:
Gender:
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 1/2 5TH AVE E
Mailing Address - Street 2:
Mailing Address - City:FLASHER
Mailing Address - State:ND
Mailing Address - Zip Code:58535-7240
Mailing Address - Country:US
Mailing Address - Phone:701-861-9148
Mailing Address - Fax:
Practice Address - Street 1:8105 7A ST NW
Practice Address - Street 2:
Practice Address - City:HALLIDAY
Practice Address - State:ND
Practice Address - Zip Code:58636-4013
Practice Address - Country:US
Practice Address - Phone:701-861-9148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator