Individual
MRS. RAULEANA BUNDREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
409 N. MAPLE STREET, CAMBRIA, IL 62915-0505
(618) 964-5664
Mailing address
PO BOX 505, CAMBRIA, IL 62915-0505
(618) 964-5664
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043123326
IL
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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