MEDICARE: AMY O'NEAL BUNCH APRN

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
1	363LA2100X	Acute Care Nurse Practitioner	26316	SC

General Provider Information

NPI Number	:	1568179497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY O'NEAL BUNCH APRN

Provider Business Mailing Address
First Line	:	111 FAIN DR
Second Line	:
City	:	BOILING SPRINGS
State	:	SC
Zip	:	29316-6030
Country	:	US
Telephone Number	:	864-909-2470
Fax Number	:

Provider Business Practice Location Address
First Line	:	380 SERPENTINE DR STE 200
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-3066
Country	:	US
Telephone Number	:	864-560-7050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2022
Last Update Date	:	11/03/2022

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