Provider Demographics
NPI:1154003879
Name:BUNCH, ADRIANN
Entity type:Individual
Prefix:
First Name:ADRIANN
Middle Name:
Last Name:BUNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44510-1650
Mailing Address - Country:US
Mailing Address - Phone:888-810-8652
Mailing Address - Fax:330-382-6525
Practice Address - Street 1:767 PARK AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44510-1650
Practice Address - Country:US
Practice Address - Phone:888-810-8652
Practice Address - Fax:330-382-6525
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health