Provider Demographics
NPI:1871936013
Name:KUNZ, GEORGE ANDREW (CRNA)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:ANDREW
Last Name:KUNZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 N BELL ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4347
Mailing Address - Country:US
Mailing Address - Phone:402-727-7990
Mailing Address - Fax:402-727-1761
Practice Address - Street 1:450 E 23RD ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2303
Practice Address - Country:US
Practice Address - Phone:402-727-7990
Practice Address - Fax:402-727-1761
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCRNA1040367500000X
NE101217367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ187429Medicare PIN