Individual
JORDAN KUNKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 STADIUM MALL DR, WEST LAFAYETTE, IN 47907-2052
(765) 494-1700
(765) 496-1227
Mailing address
601 STADIUM MALL DR, WEST LAFAYETTE, IN 47907-2052
(765) 494-1700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28222815A
IN
363L00000X
Nurse Practitioner
Primary
71009389A
IN
363LG0600X
Gerontology Nurse Practitioner
71009389A
IN
Other
Enumeration date
01/16/2019
Last updated
08/23/2023
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