Provider Demographics
NPI:1689267403
Name:KUNZ, ELIZABETH IRENE (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:IRENE
Last Name:KUNZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 BLACKSHIRE PATH
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-1857
Mailing Address - Country:US
Mailing Address - Phone:612-790-4917
Mailing Address - Fax:
Practice Address - Street 1:5810 BLACKSHIRE PATH
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-1857
Practice Address - Country:US
Practice Address - Phone:612-790-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-189971-5163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health