Healthcare Provider Details

I. General information

NPI: 1700123437
Provider Name (Legal Business Name): ADRIAN LYNN DUNN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2013
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N PINE ST
PITTSBURG KS
66762-4756
US

IV. Provider business mailing address

15483 SUMAC RD
JASPER MO
64755-7239
US

V. Phone/Fax

Practice location:
  • Phone: 620-231-9072
  • Fax:
Mailing address:
  • Phone: 417-629-4689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2013001156
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number91183
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43-557396
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: