Provider Demographics
NPI:1114327392
Name:BUNALES, KRISTIN LOUISE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LOUISE
Last Name:BUNALES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 WEDDINGTON AVE APT 2344
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2740
Mailing Address - Country:US
Mailing Address - Phone:301-904-9870
Mailing Address - Fax:
Practice Address - Street 1:2544 WEDDINGTON AVE APT 2344
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2740
Practice Address - Country:US
Practice Address - Phone:301-904-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24511183500000X
PARP448973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist