Healthcare Provider Details

I. General information

NPI: 1891932513
Provider Name (Legal Business Name): HOLLY M DUNNINGTON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2009
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR SW
HUNTSVILLE AL
35801-6455
US

IV. Provider business mailing address

500 NORTHRIDGE RD STE 330
ATLANTA GA
30350-3314
US

V. Phone/Fax

Practice location:
  • Phone: 256-469-7895
  • Fax: 256-270-8937
Mailing address:
  • Phone: 256-469-7895
  • Fax: 256-270-8937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number081414
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: