Healthcare Provider Details

I. General information

NPI: 1023975299
Provider Name (Legal Business Name): BRIANNE DUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N WEST AVE
JACKSON MI
49202-2179
US

IV. Provider business mailing address

2465 W KIMMEL RD
JACKSON MI
49201-9783
US

V. Phone/Fax

Practice location:
  • Phone: 517-789-1209
  • Fax:
Mailing address:
  • Phone: 517-416-9573
  • Fax: 517-416-9573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704315083
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: