Healthcare Provider Details

I. General information

NPI: 1689671521
Provider Name (Legal Business Name): KYANNA SHELAR KUNTZ APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HUEBNER RD FL 2
FORT RILEY KS
66442-4030
US

IV. Provider business mailing address

650 HUEBNER RD FL 2
FORT RILEY KS
66442-4030
US

V. Phone/Fax

Practice location:
  • Phone: 785-239-3627
  • Fax: 785-239-7240
Mailing address:
  • Phone: 785-239-3627
  • Fax: 785-239-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number53-64086-031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: