Healthcare Provider Details

I. General information

NPI: 1942775150
Provider Name (Legal Business Name): BUNDUKAMARA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 SINTON RD STE 104
COLORADO SPRINGS CO
80907-5085
US

IV. Provider business mailing address

3720 SINTON RD STE 104
COLORADO SPRINGS CO
80907-5085
US

V. Phone/Fax

Practice location:
  • Phone: 719-493-9555
  • Fax:
Mailing address:
  • Phone: 719-493-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CRISTI BUNDUKAMARA
Title or Position: PRESIDENT AND FOUNDER
Credential: ED.D, APN, PMHNP-BC
Phone: 719-493-9555