Provider Demographics
NPI:1750687588
Name:BUNTING, JUDITH ANN (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:BUNTING
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2034 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-7541
Mailing Address - Country:US
Mailing Address - Phone:785-410-5150
Mailing Address - Fax:
Practice Address - Street 1:503 GRANT AVE
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432-2931
Practice Address - Country:US
Practice Address - Phone:785-587-4300
Practice Address - Fax:785-458-7358
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS96342163W00000X
KS53-75305-042363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily