Provider Demographics
NPI:1891004644
Name:KUNZ, JESSIE L (CNM MSN)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:L
Last Name:KUNZ
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Gender:F
Credentials:CNM MSN
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Other - First Name:
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Mailing Address - Street 1:8301 GOLDEN VALLEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4435
Mailing Address - Country:US
Mailing Address - Phone:763-520-2211
Mailing Address - Fax:763-520-2222
Practice Address - Street 1:8301 GOLDEN VALLEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4435
Practice Address - Country:US
Practice Address - Phone:763-520-2211
Practice Address - Fax:763-520-2222
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CTCNM0121367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife