MEDICARE: LISA L.B. KUNZ ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP30005792	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851349807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA L.B. KUNZ ARNP

Provider Business Mailing Address
First Line	:	611 N IRON BRIDGE WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-4932
Country	:	US
Telephone Number	:	509-444-8888
Fax Number	:	509-444-7806

Provider Business Practice Location Address
First Line	:	5901 N LIDGERWOOD ST STE 126
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-434-1990
Fax Number	:	509-340-8986

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	09/23/2021

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