Provider Demographics
NPI:1356712988
Name:BUNN, SHEMEKA TARONCE (LPN)
Entity type:Individual
Prefix:MS
First Name:SHEMEKA
Middle Name:TARONCE
Last Name:BUNN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:SHEMEKA
Other - Middle Name:TARONCE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:5 ESQUIRE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-5336
Mailing Address - Country:US
Mailing Address - Phone:585-436-4642
Mailing Address - Fax:
Practice Address - Street 1:5 ESQUIRE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-5336
Practice Address - Country:US
Practice Address - Phone:585-436-4642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10-276974164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse