| Doctor Name: | MRS. JACQUELINE L. KUNZ |
| NPI Number: | 1699958843 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNC, NNP |
| License Number: | 109569 |
| Business Practice Address: | 9515 Holy Cross Ln Breese, IL - 622303618 |
| Business Phone Number: | 6185264511 |
| Business Fax Number: | 6185264537 |
| Mailing Address: | 9515 Holy Cross Ln, BREESE |
| State: | IL |
| Postal Code: | 622303618 |
| Phone Number: | 6185264511 |
| Fax Number: | 6185264537 |
| NPI Enumeration Date: | 12/11/2007 |
| NPI Last Update Date: | 07/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0000X |
| License Number: | 109569 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal |
| Taxonomy Definition: | |