Healthcare Provider Details
I. General information
NPI: 1841253408
Provider Name (Legal Business Name): BUD W ZUNINO ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/06/2006
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3175 POCAHONTAS RD
BAKER CITY OR
97814-1434
US
IV. Provider business mailing address
3195 N 2ND ST
BAKER CITY OR
97814-1809
US
V. Phone/Fax
- Phone: 541-523-4415
- Fax: 541-523-2399
- Phone: 360-357-8822
- Fax: 541-523-2399
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | AP30005998 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 200750136NP |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: