Basic Information
| Provider Information | |||||||||
| NPI: | 1013422344 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ONKUNDI | ||||||||
| FirstName: | ROSELYNE | ||||||||
| MiddleName: | BONARERI | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 COMMERCE PLAZA CIR | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283727386 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105212900 | ||||||||
| FaxNumber: | 9107759165 | ||||||||
| Practice Location | |||||||||
| Address1: | 507 LAUCHWOOD DR | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283525502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105064682 | ||||||||
| FaxNumber: | 9105064729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2017 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0705X | 247985 | NC | N | Nursing Service Providers | Registered Nurse | Medical-Surgical | 363LA2200X | AG10170233 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | NN1072A | 01 | NC | MEDICARE | OTHER | A-G10170233 | 01 | AANP CERTIFICATION | OTHER | 1013422344 | 05 | NC | MEDICAID | 19UGN | 01 | NC | BCBSNC | OTHER |