Provider Demographics
NPI:1689975666
Name:KUNKEL, DENISE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3059 CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4844
Mailing Address - Country:US
Mailing Address - Phone:435-649-5435
Mailing Address - Fax:
Practice Address - Street 1:1850 W 2100 S
Practice Address - Street 2:PHARMACY OPERATIONS
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-1304
Practice Address - Country:US
Practice Address - Phone:435-513-5435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT147634-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist