Healthcare Provider Details

I. General information

NPI: 1992210389
Provider Name (Legal Business Name): MOLLY KUNZLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY WINDER ARNP

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 NE ANTIOCH RD STE 2
GLADSTONE MO
64119-2375
US

IV. Provider business mailing address

2900 NE 60TH ST STE 100
KANSAS CITY MO
64119-2091
US

V. Phone/Fax

Practice location:
  • Phone: 816-452-4488
  • Fax:
Mailing address:
  • Phone: 816-872-1861
  • Fax: 816-454-2258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5377961031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: