Provider Demographics
NPI:1134481633
Name:BUNNELL, ANN ELIZABETH (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:ELIZABETH
Last Name:BUNNELL
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:ELIZABETH
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CGC
Mailing Address - Street 1:190 NEWHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1402
Mailing Address - Country:US
Mailing Address - Phone:469-507-1498
Mailing Address - Fax:
Practice Address - Street 1:12221 MERIT DR STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3100
Practice Address - Country:US
Practice Address - Phone:469-507-1498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
TX170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS