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General NPI Number Information
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NPI Number | 1710423165
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Entity Type | Individual
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Provider Name | JENNIFER BROOKE KUNSTBECK NP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 3651 WHEELER RD
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City | AUGUSTA
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State | GA
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Zip | 30909-6426
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Country | US
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Telephone | 706-651-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 6628 RIDGE RD
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City | APPLING
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State | GA
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Zip | 30802-4206
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Country | US
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Telephone | 717-279-1011
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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 | NP159658
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001238123
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License Number State | GA
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