Healthcare Provider Details

I. General information

NPI: 1346868148
Provider Name (Legal Business Name): NIKKOLE ROBYN DUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 KINGS COUNTY DR STE 102
HANFORD CA
93230-5954
US

IV. Provider business mailing address

530 KINGS COUNTY DR STE 102
HANFORD CA
93230-5954
US

V. Phone/Fax

Practice location:
  • Phone: 559-415-6737
  • Fax: 559-422-6114
Mailing address:
  • Phone: 559-415-6737
  • Fax: 559-422-6114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95211169
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: