Basic Information
| Provider Information | |||||||||
| NPI: | 1144680281 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUNOLNA | ||||||||
| FirstName: | RUTH ABIGAIL | ||||||||
| MiddleName: | |||||||||
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| Credential: | CRNP, DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6400 SHAFER CT STE 700 | ||||||||
| Address2: | |||||||||
| City: | ROSEMONT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600184989 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3463761702 | ||||||||
| FaxNumber: | 2245322780 | ||||||||
| Practice Location | |||||||||
| Address1: | 5457 TWIN KNOLLS RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210453263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105897400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2016 | ||||||||
| LastUpdateDate: | 06/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | R175276 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LP2300X | R175276 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 363LA2200X | R175276 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.