Individual
GARRETT RILEY BUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
1430 LINDBERG DR, SLIDELL, LA 70458-8056
(985) 781-7337
(844) 743-3349
Mailing address
59101 AMBER ST, SLIDELL, LA 70461-3708
(985) 646-1580
(888) 863-4274
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
202909
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202909
LOUISIANA BOARD OF NURSING
LA
Enumeration date
05/21/2019
Last updated
05/21/2019
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