Provider Demographics
NPI:1588303291
Name:KUNZE, KATHY MARIE (FNP)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:MARIE
Last Name:KUNZE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26015 RA HWY
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-9290
Mailing Address - Country:US
Mailing Address - Phone:913-708-4668
Mailing Address - Fax:
Practice Address - Street 1:1700 RAINBOW BOULVARD
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024
Practice Address - Country:US
Practice Address - Phone:816-630-6722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011037495163WH1000X
MO2022021375207Q00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine