Healthcare Provider Details

I. General information

NPI: 1720021819
Provider Name (Legal Business Name): MARY DUNN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRL MEDICINE (111)
RIVIERA BEACH FL
33410-7417
US

IV. Provider business mailing address

7305 N MILITARY TRL MEDICINE (111)
RIVIERA BEACH FL
33410-7417
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-6650
  • Fax: 561-422-8708
Mailing address:
  • Phone: 561-422-6650
  • Fax: 561-422-8708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP1046342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: