Provider Demographics
NPI:1013217801
Name:KUNZ, KRISTIN MARIE
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARIE
Last Name:KUNZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 EAST MAIN AVE
Mailing Address - Street 2:P.O BOX 236
Mailing Address - City:FRAZEE
Mailing Address - State:MN
Mailing Address - Zip Code:56544-0236
Mailing Address - Country:US
Mailing Address - Phone:218-334-2434
Mailing Address - Fax:218-334-3534
Practice Address - Street 1:111 EAST MAIN AVE
Practice Address - Street 2:
Practice Address - City:FRAZEE
Practice Address - State:MN
Practice Address - Zip Code:56544
Practice Address - Country:US
Practice Address - Phone:218-334-2434
Practice Address - Fax:218-334-3534
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker