Provider Demographics
NPI:1003342551
Name:KUNNEN, KATHERINE E (DNP, FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:E
Last Name:KUNNEN
Suffix:
Gender:F
Credentials:DNP, FNP-C, PMHNP-BC
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:ELIZABETH EUNJEE
Other - Last Name:PRUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:107 ALTEN AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-3703
Mailing Address - Country:US
Mailing Address - Phone:734-223-4562
Mailing Address - Fax:
Practice Address - Street 1:3300 36TH ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-2810
Practice Address - Country:US
Practice Address - Phone:616-942-2110
Practice Address - Fax:616-942-9548
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704274169363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily