Provider Demographics
NPI:1861800013
Name:BUNNELL, ALLISON MARGARET (NP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARGARET
Last Name:BUNNELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2580
Mailing Address - Country:US
Mailing Address - Phone:607-687-0350
Mailing Address - Fax:607-684-0333
Practice Address - Street 1:42 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-1578
Practice Address - Country:US
Practice Address - Phone:607-687-0305
Practice Address - Fax:607-687-0333
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily