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General NPI Number Information
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NPI Number | 1619594959
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Entity Type | Individual
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Provider Name | MARSTIE SUE BUNTING D-NP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 611 E MAIN ST
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City | HART
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State | MI
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Zip | 49420-1190
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Country | US
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Telephone | 231-873-6900
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Fax | 231-873-1825
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Provider Business Mailing Address
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Address Line | 4551 SEYMOUR DR
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City | NEW ERA
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State | MI
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Zip | 49446-9604
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Country | US
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Telephone | 231-301-0473
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 4704301681
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704301681
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License Number State | MI
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