Healthcare Provider Details

I. General information

NPI: 1396982872
Provider Name (Legal Business Name): NANCY JANE KUNKEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY JANE ROMANOW APRN

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STATE ST
FRAMINGHAM MA
01702-2499
US

IV. Provider business mailing address

100 STATE ST
FRAMINGHAM MA
01702-2499
US

V. Phone/Fax

Practice location:
  • Phone: 508-626-4900
  • Fax:
Mailing address:
  • Phone: 508-626-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number154266
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number154266
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number154266
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: