Individual
CAROL BUENTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
420 W MAGNETIC ST, MARQUETTE, MI 49855-2700
(906) 225-3406
Mailing address
374 N NOREN LAKE DR, GWINN, MI 49841-9062
(906) 360-6800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10078
WI
363LN0000X
Neonatal Nurse Practitioner
4704222255
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100178486
—
WI
Enumeration date
07/09/2013
Last updated
08/27/2024
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