Provider Demographics
NPI:1376728063
Name:BUNDY, LEEANNE M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEEANNE
Middle Name:M
Last Name:BUNDY
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 1:165 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-2329
Mailing Address - Country:US
Mailing Address - Phone:724-543-2265
Mailing Address - Fax:724-548-2793
Practice Address - Street 1:165 BUTLER RD
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2329
Practice Address - Country:US
Practice Address - Phone:724-543-2265
Practice Address - Fax:724-548-2793
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist