Provider Demographics
NPI:1003476904
Name:UNRUH, KRISTI D (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:D
Last Name:UNRUH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 70TH
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-8100
Mailing Address - Country:US
Mailing Address - Phone:620-345-6867
Mailing Address - Fax:
Practice Address - Street 1:1755 E 61ST ST N
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:KS
Practice Address - Zip Code:67219-1917
Practice Address - Country:US
Practice Address - Phone:316-440-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78684-101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily