Healthcare Provider Details

I. General information

NPI: 1396274585
Provider Name (Legal Business Name): REBECCA KUNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 06/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24892 JOHN J WILLIAMS HWY
MILLSBORO DE
19966-4939
US

IV. Provider business mailing address

32279 AUGUSTA CT
LEWES DE
19958-5423
US

V. Phone/Fax

Practice location:
  • Phone: 302-947-1204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0004941
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: