MEDICARE: MARIBEL VERAGARA BUNICH FNP

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	363LF0000X	Family Nurse Practitioner	5019456	NC

General Provider Information

NPI Number	:	1982478582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL VERAGARA BUNICH FNP

Provider Business Mailing Address
First Line	:	715 SARDIS LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-6513
Country	:	US
Telephone Number	:	704-450-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 OLD PINEVILLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-4106
Country	:	US
Telephone Number	:	866-299-4968
Fax Number	:

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

Provider Enumeration Date	:	11/14/2023
Last Update Date	:	03/12/2026

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