Provider Demographics
NPI:1730972001
Name:GUNN, KRISTEN (DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:GUNN
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:HOLCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27664 HIGHWAY 139
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64659-8443
Mailing Address - Country:US
Mailing Address - Phone:660-349-6001
Mailing Address - Fax:
Practice Address - Street 1:2400 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-9620
Practice Address - Country:US
Practice Address - Phone:573-290-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140299432255A2300X
MO2014026962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer