KENNETH JAMES GUNDERSON FNP-C NPI 1659149086

NPI Information

  • NPI: 1659149086
  • Provider Name: KENNETH JAMES GUNDERSON, FNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1950 SAINT CLAIR RD
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 569-8249

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NPI Details

Kenneth James Gunderson, FNP-C is a family nurse practitioner in Idaho Falls, ID with 2 years of experience. Kenneth James Gunderson, FNP-C NPI is 1659149086. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1950 SAINT CLAIR RD
IDAHO FALLS, ID
ZIP 83404-306
Phone: (208) 569-8249

The NPI 1659149086 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/14/2023 and was last updated on 2/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyF12230320IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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