Provider Demographics
NPI:1427185792
Name:BUNCE, GAIL EVELYN (ADULT NP, BC)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:EVELYN
Last Name:BUNCE
Suffix:
Gender:F
Credentials:ADULT NP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 KIWANEE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-4040
Mailing Address - Country:US
Mailing Address - Phone:401-463-5312
Mailing Address - Fax:
Practice Address - Street 1:208 COLLYER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-1560
Practice Address - Country:US
Practice Address - Phone:401-793-2355
Practice Address - Fax:401-793-7624
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP18642363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RINPP18642OtherNP STATE LICENSE
RIRO5264OtherUNITED HEALTH PLAN
RI406995OtherBLUE CHIP
RI2767-8OtherBLUE CROSS BLUE SHIELD
RI9002767Medicaid
RI2767-8OtherBLUE CROSS BLUE SHIELD