Provider Demographics
NPI:1740536184
Name:BUNKHOLT, AMANDA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BUNKHOLT
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 ARBORETUM PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-5407
Mailing Address - Country:US
Mailing Address - Phone:804-405-2992
Mailing Address - Fax:833-525-0063
Practice Address - Street 1:9201 ARBORETUM PKWY STE 300
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-5407
Practice Address - Country:US
Practice Address - Phone:804-520-4600
Practice Address - Fax:833-525-0063
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170133363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health