Individual
SHANNON D. BUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
140 BRYAN BLVD, CORBIN, KY 40701-2775
(606) 523-2005
(606) 546-9363
Mailing address
1595 BEE CREEK RD, CORBIN, KY 40701-8813
(606) 528-6527
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3006842
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100166150
—
KY
Enumeration date
02/10/2011
Last updated
11/07/2018
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