Mary Bunch, FNP
Nurse Practitioner, Family in Jefferson City, MO. Individual provider (NPI-1).
NPI number1396296331
StatusActive
Last updated in NPPESJun 28, 2023
Details
- NPI
- 1396296331
- Entity type
- Individual (NPI-1)
- Name
- Mary Bunch
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 14, 2016
- Certification date
- Jun 28, 2023
- Last updated
- Jun 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 2023020074 | MO | Yes |
| 363LW0102X | Nurse Practitioner, Women's Health | 2016036971 | MO |
Other names
- Mary Risinger (Former Name)
Practice location
1241 W Stadium BlvdJefferson City, MO 65109-6023
Phone 573-635-5264
Mailing address
1241 W Stadium BlvdJefferson City, MO 65109-6023
Phone 573-635-5264
Other practice locations
1735 Elm Ct
Jefferson City, MO 65101-4129
Jefferson City, MO 65101-4129
Phone 573-634-4878
350 Country Meadow Ln
Fulton, MO 65251-5278
Fulton, MO 65251-5278
Phone 573-634-4878
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