Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | A060979 | IA |
Y | 363L00000X | Nurse Practitioner | A060979 | IA |
NPI | 1003898776 |
---|---|
Provider Name | Terri L Bunting |
First Address | Des Moines, IA 50305-1475 |
Second Address | West Des Moines, IA 50265-6967 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 18/07/2016 |