Individual
STACY BUNTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 EAST CARPENTER STREET, ROOM 2K64, SPRINGFIELD, IL 62769-0001
(217) 525-5643
(217) 544-3311
Mailing address
800 EAST CARPENTER STREET, ROOM 2K64, SPRINGFIELD, IL 62769-0001
(217) 525-5643
(217) 544-3311
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209005948
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041334433
—
IL
01
—
0841504038
BLUE CROSS
IL
01
—
104409
HEALTHLINK GROUP #
IL
01
—
371115308
CHAMPUS/TRICARE
IL
01
—
735721
HEALTHLINK INDIVIDUAL #
IL
Enumeration date
04/26/2006
Last updated
12/29/2021
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