Provider Demographics
NPI:1427150747
Name:SCHUNK, KIMBERLY KURTZ (FNP-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KURTZ
Last Name:SCHUNK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:KURTZ SCHUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5007 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-9576
Mailing Address - Country:US
Mailing Address - Phone:585-613-6178
Mailing Address - Fax:
Practice Address - Street 1:3 HONEOYE CMNS
Practice Address - Street 2:
Practice Address - City:HONEOYE
Practice Address - State:NY
Practice Address - Zip Code:14471-8807
Practice Address - Country:US
Practice Address - Phone:585-229-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0029977363LF0000X
NYF331061363LF0000X
IL209.006779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP019331061OtherEXCELLUS
NY109173BFOtherPREFERRED CARE
NYP019331061OtherEXCELLUS
NYCC2636Medicare ID - Type Unspecified