Provider Demographics
NPI:1679887491
Name:KUNTZ, KATHLEEN RYAN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:RYAN
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:1700 HORIZON DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3950
Mailing Address - Country:US
Mailing Address - Phone:215-997-0890
Mailing Address - Fax:215-997-9652
Practice Address - Street 1:1700 HORIZON DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3950
Practice Address - Country:US
Practice Address - Phone:215-997-0890
Practice Address - Fax:215-997-9652
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP010369363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily