Provider Demographics
NPI:1336539162
Name:BUNCH, JOANNA MAUREEN (FNP-C)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MAUREEN
Last Name:BUNCH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:MAUREEN
Other - Last Name:TURNBOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1415 ELMWOOD DR. N
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301
Mailing Address - Country:US
Mailing Address - Phone:217-653-2998
Mailing Address - Fax:
Practice Address - Street 1:101 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:IL
Practice Address - Zip Code:62363-1436
Practice Address - Country:US
Practice Address - Phone:217-285-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily