Provider Demographics
NPI:1942595822
Name:KUNKE, TRENIE (RPH)
Entity Type:Individual
Prefix:
First Name:TRENIE
Middle Name:
Last Name:KUNKE
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 1:601 N STEPHANIE ST
Mailing Address - Street 2:T0680
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2612
Mailing Address - Country:US
Mailing Address - Phone:702-451-0034
Mailing Address - Fax:702-451-0034
Practice Address - Street 1:601 N STEPHANIE ST
Practice Address - Street 2:T0680
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2612
Practice Address - Country:US
Practice Address - Phone:702-451-0034
Practice Address - Fax:702-451-0034
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist