Provider Demographics
NPI:1154038818
Name:BUNJO, JOANITA (RN)
Entity type:Individual
Prefix:
First Name:JOANITA
Middle Name:
Last Name:BUNJO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOANITA
Other - Middle Name:
Other - Last Name:BUNJO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:26 PUTNAM RD APT 2
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2113
Mailing Address - Country:US
Mailing Address - Phone:617-642-6091
Mailing Address - Fax:
Practice Address - Street 1:26 PUTNAM RD APT 2
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2113
Practice Address - Country:US
Practice Address - Phone:617-642-6091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2346955163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse