Provider Demographics
NPI:1497033161
Name:KUNKEL, JENNIFER MITCHELL (PHARMD, BCPS, BCCCP)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MITCHELL
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:PHARMD, BCPS, BCCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 KEELY CT
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2979
Mailing Address - Country:US
Mailing Address - Phone:610-509-8070
Mailing Address - Fax:
Practice Address - Street 1:45 CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1412
Practice Address - Country:US
Practice Address - Phone:215-782-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP 4414081835P0018X
PARP441408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist