Healthcare Provider Details

I. General information

NPI: 1982362851
Provider Name (Legal Business Name): ALEXIS KUNZ PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2021
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 4TH ST SW STE 110
MASON CITY IA
50401-2856
US

IV. Provider business mailing address

1010 4TH ST SW STE 110
MASON CITY IA
50401-2856
US

V. Phone/Fax

Practice location:
  • Phone: 641-428-6100
  • Fax: 641-428-6107
Mailing address:
  • Phone: 641-428-6100
  • Fax: 641-428-6107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21237
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: