Healthcare Provider Details

I. General information

NPI: 1588303291
Provider Name (Legal Business Name): KATHY MARIE KUNZE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 RAINBOW BOULVARD
EXCELSIOR SPRINGS MO
64024
US

IV. Provider business mailing address

26015 RA HWY
KEARNEY MO
64060-9290
US

V. Phone/Fax

Practice location:
  • Phone: 816-630-6722
  • Fax:
Mailing address:
  • Phone: 913-708-4668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2022021375
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2022021375
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number81769
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number2011037495
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: