Provider Demographics
NPI:1548424989
Name:BUNCE, GAIL P (APRN)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:P
Last Name:BUNCE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 CHARTER OAK AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1912
Mailing Address - Country:US
Mailing Address - Phone:860-289-8131
Mailing Address - Fax:860-289-8380
Practice Address - Street 1:474 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-1149
Practice Address - Country:US
Practice Address - Phone:860-289-8131
Practice Address - Fax:860-289-8380
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000956363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner