Provider Demographics
NPI:1275048969
Name:BUNKERS, KENDRA KAY
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:KAY
Last Name:BUNKERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 MEYER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-8040
Mailing Address - Country:US
Mailing Address - Phone:402-564-7871
Mailing Address - Fax:
Practice Address - Street 1:818 E 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3866
Practice Address - Country:US
Practice Address - Phone:402-563-4571
Practice Address - Fax:402-563-3951
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist