Individual
LAUREN AILEEN BUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
415 N 9TH ST # 4W16, SPRINGFIELD, IL 62702-5303
(217) 545-8000
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041429321
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209025098
IL
Other
Enumeration date
04/22/2020
Last updated
09/01/2022
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