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Individual

JUDITH KUNKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
3998 RED LION RD, EMERGENCY ROOM, PHILADELPHIA, PA 19114-1436
(215) 612-4000
(215) 807-8235
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
VP004682B
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
257219
HIGHMARK BLUE SHIELD
PA
Enumeration date
01/29/2007
Last updated
07/08/2007
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