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General NPI Number Information
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NPI Number | 1043197619
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Entity Type | Individual
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Provider Name | REBECCA BUNCH NP
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 301 MARKET DR STE G
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City | EMPORIA
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State | VA
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Zip | 23847-1220
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Country | US
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Telephone | 434-230-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 804 E 12TH ST
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City | ROANOKE RAPIDS
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State | NC
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Zip | 27870-3937
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024194276
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License Number State | VA
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