Provider Demographics
NPI:1598951386
Name:BUNNEY GALLEGOS, DIANNE CATHERINE (MS)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:CATHERINE
Last Name:BUNNEY GALLEGOS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:
Other - Last Name:BUNNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1666 S STUART ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4457
Mailing Address - Country:US
Mailing Address - Phone:303-842-1512
Mailing Address - Fax:303-936-4424
Practice Address - Street 1:1666 S STUART ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-4457
Practice Address - Country:US
Practice Address - Phone:303-842-1512
Practice Address - Fax:303-936-4424
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO414246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic