Provider Demographics
NPI:1972641058
Name:KUNZ, PATRICIA L (LPN)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:L
Last Name:KUNZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N12726 HARPER RD
Mailing Address - Street 2:
Mailing Address - City:ATHELSTANE
Mailing Address - State:WI
Mailing Address - Zip Code:54104-9482
Mailing Address - Country:US
Mailing Address - Phone:715-757-3097
Mailing Address - Fax:
Practice Address - Street 1:N12726 HARPER RD
Practice Address - Street 2:
Practice Address - City:ATHELSTANE
Practice Address - State:WI
Practice Address - Zip Code:54104-9482
Practice Address - Country:US
Practice Address - Phone:715-757-3097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33297-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse