Provider Demographics
NPI:1861961260
Name:KUNTZ, VICTORIA KIMBERLY (AGAC-NP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:KIMBERLY
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:AGAC-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 SEABRIGHT CT
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-4669
Mailing Address - Country:US
Mailing Address - Phone:410-858-7785
Mailing Address - Fax:
Practice Address - Street 1:219 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2913
Practice Address - Country:US
Practice Address - Phone:410-822-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201609363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care