Provider Demographics
NPI:1720347719
Name:BUNDY, LINDA MAE (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MAE
Last Name:BUNDY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2874 N CARSON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-1682
Mailing Address - Country:US
Mailing Address - Phone:775-445-7170
Mailing Address - Fax:775-687-8457
Practice Address - Street 1:2874 N CARSON ST STE 200
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-1682
Practice Address - Country:US
Practice Address - Phone:775-445-7170
Practice Address - Fax:775-687-8457
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-46723363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care