Healthcare Provider Details

I. General information

NPI: 1972414464
Provider Name (Legal Business Name): KIMBERLY KUNTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 NEBRASKA AVE
TOLEDO OH
43604-8540
US

IV. Provider business mailing address

1038 SYCAMORE LN
TEMPERANCE MI
48182-1267
US

V. Phone/Fax

Practice location:
  • Phone: 419-671-5400
  • Fax:
Mailing address:
  • Phone: 614-464-7122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.427766
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: