Bunga Maythresa Siahaan, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN.1672616 Issued in CO

Practice address

14437 E 1St Dr Apt C10
Aurora, CO 80011-8777

Phone

(951) 380-6965

NPI assigned

Jun 5, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622851200000",
    "number": "1558938928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14437 E 1ST DR APT C10",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118777",
            "telephone_number": "951-380-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14437 E 1ST DR APT C10",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118777",
            "telephone_number": "951-380-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAHAAN",
        "first_name": "BUNGA",
        "middle_name": "MAYTHRESA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-05",
        "last_updated": "2021-06-05",
        "certification_date": "2021-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1672616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Shur, OTR/L:
• Bonita A Shviraga, MS-CNM
• Julia Wynne Shwayder
• Jasmine Diane McCorkle Shytle, WHNP
• Abdimajid Siad
• Sarah Elizabeth Sibbel, MD
• Hananeya Sibhatu
• Jesus Sicairos Rivera
• Najmul Hasan Siddiqui, M.D.
• Sameer Haroon Siddiqui, M.D.

• Registered Nurse in Aurora, CO
• Providers in Aurora, CO by specialty
• Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.