Individual
TARA CHRISTINE BUNCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1209 N MOUND ST, NACOGDOCHES, TX 75961-4028
(936) 585-4646
Mailing address
PO BOX 631310, NACOGDOCHES, TX 75963-1310
(936) 585-4646
(936) 585-4645
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP140471
TX
Other
Enumeration date
02/07/2019
Last updated
09/29/2019
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