Provider Demographics
NPI:1083429955
Name:GUNKEL, JEANETTE MARIE (RN)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:MARIE
Last Name:GUNKEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 W 52ND CIR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-1816
Mailing Address - Country:US
Mailing Address - Phone:620-385-0063
Mailing Address - Fax:
Practice Address - Street 1:10600 W 52ND CIR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-1816
Practice Address - Country:US
Practice Address - Phone:816-922-2411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-51334-071163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty