Healthcare Provider Details

I. General information

NPI: 1841127180
Provider Name (Legal Business Name): KAREN DUNNIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19670 FORT ST APT 103
RIVERVIEW MI
48193-6749
US

IV. Provider business mailing address

19670 FORT STREET APT 103
RIVERVIEW MI
48193
US

V. Phone/Fax

Practice location:
  • Phone: 313-717-6744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number4703096693
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: