MEDICARE: GINA KUENZI RN, MSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	744082	TX

General Provider Information

NPI Number	:	1740524495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA KUENZI RN, MSN

Provider Business Mailing Address
First Line	:	3650 CHICORA CT
Second Line	:	# 321
City	:	FORT WORTH
State	:	TX
Zip	:	76116-5813
Country	:	US
Telephone Number	:	361-318-4588
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 CHICORA CT
Second Line	:	# 321
City	:	FORT WORTH
State	:	TX
Zip	:	76116-5813
Country	:	US
Telephone Number	:	361-318-4588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2012
Last Update Date	:	11/19/2012

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