Provider Demographics
NPI:1770814980
Name:BUNCE, LYNNE M (LPN)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:M
Last Name:BUNCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-6043
Mailing Address - Country:US
Mailing Address - Phone:315-342-4680
Mailing Address - Fax:
Practice Address - Street 1:39 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-6043
Practice Address - Country:US
Practice Address - Phone:315-342-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239077164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse