Provider Demographics
NPI:1952407223
Name:KUNIN, JEAN ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:ELLEN
Last Name:KUNIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:ELLEN
Other - Last Name:KUNIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PC
Mailing Address - Street 1:4495 HALE PKWY STE 303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-6204
Mailing Address - Country:US
Mailing Address - Phone:303-506-3146
Mailing Address - Fax:303-322-3609
Practice Address - Street 1:4495 HALE PKWY STE 303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-6204
Practice Address - Country:US
Practice Address - Phone:303-506-3146
Practice Address - Fax:303-322-3609
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO 259082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01259084Medicaid
D24719Medicare UPIN
CO01259084Medicaid