Individual
TRACY L KUNKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
763 BURNSIDE AVE, UNIT 5, EAST HARTFORD, CT 06108-2791
(860) 291-9787
Mailing address
111 FOUNDERS PLZ, STE 1802, EAST HARTFORD, CT 06108-8301
(860) 569-5900
(860) 310-2127
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
003553
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236346
—
CT
Enumeration date
11/09/2010
Last updated
01/25/2018
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