Provider Demographics
NPI:1437371457
Name:BUNTING, SHELLEY K (FNP)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:K
Last Name:BUNTING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 HEALTH PARK DR STE 150
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6936
Mailing Address - Country:US
Mailing Address - Phone:919-772-3487
Mailing Address - Fax:919-772-3446
Practice Address - Street 1:501 HEALTH PARK DR STE 150
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6936
Practice Address - Country:US
Practice Address - Phone:919-772-3487
Practice Address - Fax:919-772-3446
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC201400OtherNC LICENSE NUMBER