Provider Demographics
NPI:1609259548
Name:KUNECKI, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:KUNECKI
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 1:5123 FULTON ST E
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9108
Mailing Address - Country:US
Mailing Address - Phone:616-437-8514
Mailing Address - Fax:
Practice Address - Street 1:5123 FULTON ST E
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-9108
Practice Address - Country:US
Practice Address - Phone:616-437-8514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care