Provider Demographics
NPI:1477985737
Name:BUNN, SANDRA DEE (CNS-PP, ACNS-BC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:DEE
Last Name:BUNN
Suffix:
Gender:F
Credentials:CNS-PP, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 OAK ST SE BLDG B
Mailing Address - Street 2:PO BOX 14001
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3905
Mailing Address - Country:US
Mailing Address - Phone:503-561-1543
Mailing Address - Fax:503-561-4719
Practice Address - Street 1:890 OAK ST SE BLDG B
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3905
Practice Address - Country:US
Practice Address - Phone:503-561-1543
Practice Address - Fax:503-561-4719
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201390180CNS-PP364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health