Individual
MRS. SONYA BUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
117 E RAY FINE BLVD, ROLAND, OK 74954-5198
(918) 427-3344
(918) 427-3375
Mailing address
117 E RAY FINE BLVD, ROLAND, OK 74954-5198
(918) 427-3344
(918) 427-3375
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
57571
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57571
NURSING LICENSE
OK
01
—
E081977023
DRIVER LICENSE
OK
Enumeration date
11/05/2020
Last updated
11/05/2020
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