Provider Demographics
NPI:1619594959
Name:BUNTING, MARSTIE SUE (D-NP)
Entity Type:Individual
Prefix:MRS
First Name:MARSTIE
Middle Name:SUE
Last Name:BUNTING
Suffix:
Gender:F
Credentials:D-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 SEYMOUR DR
Mailing Address - Street 2:
Mailing Address - City:NEW ERA
Mailing Address - State:MI
Mailing Address - Zip Code:49446-9604
Mailing Address - Country:US
Mailing Address - Phone:231-301-0473
Mailing Address - Fax:
Practice Address - Street 1:611 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-1190
Practice Address - Country:US
Practice Address - Phone:231-873-6900
Practice Address - Fax:231-873-1825
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704301681363LG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology