Individual
MARY BUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
Mailing address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2023020074
MO
363LW0102X
Women's Health Nurse Practitioner
2016036971
MO
Other
Enumeration date
10/14/2016
Last updated
06/28/2023
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