Provider Demographics
NPI:1740853076
Name:KUNKA, KRISTEN (FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:KUNKA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 CORALBERRY CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1345
Mailing Address - Country:US
Mailing Address - Phone:703-477-7994
Mailing Address - Fax:
Practice Address - Street 1:41816 FENWAY CIR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-8069
Practice Address - Country:US
Practice Address - Phone:347-761-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily