Provider Demographics
NPI:1508939356
Name:BUNDE, KATHY A
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:A
Last Name:BUNDE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KATHY
Other - Middle Name:A
Other - Last Name:BUNDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DT
Mailing Address - Street 1:10615 MAINE DR
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7073
Mailing Address - Country:US
Mailing Address - Phone:219-662-9409
Mailing Address - Fax:219-662-9409
Practice Address - Street 1:10615 MAINE DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7073
Practice Address - Country:US
Practice Address - Phone:219-662-9409
Practice Address - Fax:219-662-9409
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist