Provider Demographics
NPI:1841852662
Name:BUNKLEY, YOLANDA LATRELL (NP-C)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:LATRELL
Last Name:BUNKLEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 SAINT MARYS RD STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-7625
Mailing Address - Country:US
Mailing Address - Phone:706-685-2770
Mailing Address - Fax:
Practice Address - Street 1:4000 SAINT MARYS RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-7625
Practice Address - Country:US
Practice Address - Phone:706-685-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN216788363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner