Provider Demographics
NPI:1417505561
Name:GUNCKEL, ANALYN RESPECIA
Entity Type:Individual
Prefix:
First Name:ANALYN
Middle Name:RESPECIA
Last Name:GUNCKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 MCGOUGAN RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4178
Mailing Address - Country:US
Mailing Address - Phone:910-818-3130
Mailing Address - Fax:
Practice Address - Street 1:1819 MCGOUGAN RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4178
Practice Address - Country:US
Practice Address - Phone:910-818-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-02
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider