Individual
KELLIE KUNKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18606 CEDAR DR E, FORT MYERS, FL 33967-3490
(586) 863-7751
Mailing address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4963
(517) 789-5903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704278856
MI
163W00000X
Registered Nurse
RN 9374213
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
4704278856
MI
Other
Enumeration date
11/21/2015
Last updated
03/31/2021
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