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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Jessie Kunkel | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| ID Number | PROMISe#: 102926330 | [sources] | |||
| NPI | 1871811059 | [sources] | |||
| Position | DO | [sources] | |||
| Last change | Last processed | First seen | |||
List of providers excluded from participating in the Delaware Medicaid program.
United States of America · DHSS
For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Pennsylvania Department of Human Services | - | |||