Provider Demographics
NPI:1942775150
Name:BUNDUKAMARA INC
Entity type:Organization
Organization Name:BUNDUKAMARA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNDUKAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, APN, PMHNP-BC
Authorized Official - Phone:719-493-9555
Mailing Address - Street 1:3720 SINTON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-5085
Mailing Address - Country:US
Mailing Address - Phone:719-493-9555
Mailing Address - Fax:
Practice Address - Street 1:3720 SINTON RD STE 104
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5085
Practice Address - Country:US
Practice Address - Phone:719-493-9555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty