Healthcare Provider Details

I. General information

NPI: 1518532084
Provider Name (Legal Business Name): TALYN DIXON DUNN APRN , PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 05/26/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14426 JAMES BOND RD
GULFPORT MS
39503-8311
US

IV. Provider business mailing address

125 STENNIS AVE
OCEAN SPRINGS MS
39564-5115
US

V. Phone/Fax

Practice location:
  • Phone: 228-328-6000
  • Fax:
Mailing address:
  • Phone: 228-219-1422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number904951
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: