Provider Demographics
NPI:1477990752
Name:BUNKER, KATHRYN JO (AUD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:JO
Last Name:BUNKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:JO
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1133 COLLEGE AVE
Mailing Address - Street 2:SUITE C145
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2751
Mailing Address - Country:US
Mailing Address - Phone:785-320-7388
Mailing Address - Fax:785-320-6056
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:SUITE C145
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2751
Practice Address - Country:US
Practice Address - Phone:785-320-7388
Practice Address - Fax:785-320-6056
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2237231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist