Provider Demographics
NPI:1841150828
Name:KUNKA, KERRY (RDN)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:KUNKA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2419
Mailing Address - Country:US
Mailing Address - Phone:484-796-1077
Mailing Address - Fax:
Practice Address - Street 1:532 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2419
Practice Address - Country:US
Practice Address - Phone:484-796-1077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005228133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered