# MS. SUSAN LYNN BUNNELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1346216975
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 5576 | SD | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | M11154 | ID | Yes |

## Other

- **Enumeration date:** 02/24/2006
- **Last updated:** 12/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 13426216975 | — | ID |
| 01 | — | 4994379 | BCBS | SD |
| 05 | — | 7101880 | — | SD |