Provider Demographics
NPI:1518636182
Name:BURNEKO, BUNCENCIA KRISTINE (RN, HN-BC, PMHNP)
Entity Type:Individual
Prefix:
First Name:BUNCENCIA
Middle Name:KRISTINE
Last Name:BURNEKO
Suffix:
Gender:F
Credentials:RN, HN-BC, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 SCHLEY AVE STE A
Mailing Address - Street 2:#68
Mailing Address - City:BRADDOCK HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21714
Mailing Address - Country:US
Mailing Address - Phone:410-498-7676
Mailing Address - Fax:
Practice Address - Street 1:4707 SCHLEY AVE STE A
Practice Address - Street 2:#68
Practice Address - City:BRADDOCK HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21714
Practice Address - Country:US
Practice Address - Phone:410-498-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR227158363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health