Provider Demographics
NPI:1043550817
Name:KUNTZ, JENNIFER JO (CRNA DNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JO
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:CRNA DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-7357
Mailing Address - Country:US
Mailing Address - Phone:642-425-0714
Mailing Address - Fax:
Practice Address - Street 1:2235 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-7357
Practice Address - Country:US
Practice Address - Phone:642-425-0714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA118903390200000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program