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NPI Code Detail

MEDICARE: MRS. EMILY R BUNN PA-C

MEDICARE: MRS. EMILY R BUNN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0110002470VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00696498OTHERVAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225180086
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY R BUNN PA-C
Provider Business Mailing Address
First Line : 1 UNIVERSITY PARK DR
Second Line :
City : NASHVILLE
State : TN
Zip : 37204-3956
Country : US
Telephone Number : 615-966-6304
Fax Number :
Provider Business Practice Location Address
First Line : 3500 N MOUNT JULIET RD
Second Line : SUITE 201
City : MOUNT JULIET
State : TN
Zip : 37122-3059
Country : US
Telephone Number : 615-758-5672
Fax Number : 615-758-5609
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 09/03/2021

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