Provider Demographics
NPI:1750365979
Name:KUNKEL, JUDITH ANN (ARNP)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4799 BLUE RIDGE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-3240
Mailing Address - Country:US
Mailing Address - Phone:706-492-3200
Mailing Address - Fax:
Practice Address - Street 1:183 LEDFORD ST
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6213
Practice Address - Country:US
Practice Address - Phone:828-837-4712
Practice Address - Fax:828-837-4808
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN206803363L00000X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004688Medicaid
GA003123928BMedicaid
NC7004688Medicaid