Provider Demographics
NPI:1093281362
Name:BUNCE, EVELYN HAYDEN (APRN-CNP, DNP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:HAYDEN
Last Name:BUNCE
Suffix:
Gender:F
Credentials:APRN-CNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 PORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-9005
Mailing Address - Country:US
Mailing Address - Phone:314-221-2467
Mailing Address - Fax:
Practice Address - Street 1:123 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3850
Practice Address - Country:US
Practice Address - Phone:207-761-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP181166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECNP181166OtherADVANCED PRACTICE REGISTERED NURSE