Healthcare Provider Details

I. General information

NPI: 1154300390
Provider Name (Legal Business Name): CAROL LYNN DUNAWAY APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL LYNN GILCHRIST APRN-BC

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 S 6TH AVE
TUCSON AZ
85723
US

IV. Provider business mailing address

10792 S SANDY LAKE DR
VAIL AZ
85641-6469
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-1450
  • Fax: 520-629-1864
Mailing address:
  • Phone: 520-979-2554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP 1230
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN110558
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP5414
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: