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General NPI Number Information
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NPI Number | 1003476904
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Entity Type | Individual
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Provider Name | KRISTI D UNRUH APRN
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Gender | Female
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 1755 E 61ST ST N
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City | PARK CITY
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State | KS
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Zip | 67219-1917
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Country | US
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Telephone | 316-440-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 372 70TH
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City | NEWTON
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State | KS
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Zip | 67114-8100
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Country | US
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Telephone | 620-345-6867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-78684-101
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License Number State | KS
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