Provider Demographics
NPI:1952523060
Name:KUNERT, JODI JEANNE (RN,RCS)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:JEANNE
Last Name:KUNERT
Suffix:
Gender:F
Credentials:RN,RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N8680 COUNTY ROAD Y
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-9461
Mailing Address - Country:US
Mailing Address - Phone:920-206-0996
Mailing Address - Fax:
Practice Address - Street 1:N8680 COUNTY ROAD Y
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-9461
Practice Address - Country:US
Practice Address - Phone:920-206-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health