Provider Demographics
NPI:1255910436
Name:KUNKLE, REBECCA LYNN (MSN, NP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:KUNKLE
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8775 NORWIN AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-7705
Mailing Address - Country:US
Mailing Address - Phone:724-765-1225
Mailing Address - Fax:724-765-1227
Practice Address - Street 1:8775 NORWIN AVE STE 108
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-7705
Practice Address - Country:US
Practice Address - Phone:724-765-1225
Practice Address - Fax:724-765-1227
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV76292163W00000X
PARN730066163W00000X
PASP024147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse