Provider Demographics
NPI:1649091893
Name:BUNNELL, LAUREN PAULINE (FNP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:PAULINE
Last Name:BUNNELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 CAMPBELL HWY
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-7627
Mailing Address - Country:US
Mailing Address - Phone:434-610-7028
Mailing Address - Fax:
Practice Address - Street 1:507 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5541
Practice Address - Country:US
Practice Address - Phone:434-984-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024191529363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily