Provider Demographics
NPI:1396982872
Name:KUNKEL, NANCY JANE (APRN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JANE
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JANE
Other - Last Name:ROMANOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:100 STATE ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-2499
Mailing Address - Country:US
Mailing Address - Phone:508-626-4900
Mailing Address - Fax:
Practice Address - Street 1:100 STATE ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-2499
Practice Address - Country:US
Practice Address - Phone:508-626-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171W00000X, 372500000X
MA154266163WA2000X, 363LF0000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No171W00000XOther Service ProvidersContractor
No372500000XNursing Service Related ProvidersChore Provider
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program