Mary Bunker, CNP
Individual provider Active NPI Family Nurse Practitioner · Mora, NM
NPI 1457481871 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457481871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R11321 (NM)
- Practice address
- State Hwy 518, Mile Marker 29
Mora, NM 87732-0185 - Phone
- (505) 387-5503
- Fax
- (505) 387-5502
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050405000117 | NM | Practitioner - Nurse Practitioner | 2365405891 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R11321 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New Mexico | Current | Accepting new patients | |
| Agnes Martinez Family Health Clinic | Past |
Accepting new patients | |
| Mora Valley Community Health Services Inc | Past | Accepting new patients | |
| Mora Valley Community Health Services, Inc. | Past | Accepting new patients |
Locations
3695 Hot Springs Blvd
Las Vegas, NM 87701
Phone (505) 454-2100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R11321 | NM | Yes |
Addresses
Primary practice location
State Hwy 518, Mile Marker 29
Mora, NM 87732-0185
Mailing address
PO Box 185
Mora, NM 87732-0185
Phone (505) 387-5503
Other providers in Mora, NM
- Roger J Ames
- Estrella C. Apolonia
- Samuel A Aragon
- Bestcare Pharmacy-Mora LLC
- Bestcare Pharmacy-Mora, LLC
- County of Mora Board of County Commissioners
- Consuelo Cruz
- Nathan Christopher Duran
- Devon Denise Fox
- William Fresquez
All providers in Mora, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.