Individual
MR. RICHARD EDWARD BUNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
6 WILDFLOWER DR., WILKES BARRE, PA 18702-3813
(570) 808-8843
(570) 808-8844
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
VP002132C
PA
363LA2200X
Adult Health Nurse Practitioner
VP002132C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468317
MEDICARE
PA
Enumeration date
08/27/2005
Last updated
03/04/2016
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