Healthcare Provider Details

I. General information

NPI: 1134461452
Provider Name (Legal Business Name): ASHLEY ANN DUNN R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 11/27/2023
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 CONWAY DR STE 200
KALISPELL MT
59901-3153
US

IV. Provider business mailing address

202 CONWAY DR STE 200
KALISPELL MT
59901-3153
US

V. Phone/Fax

Practice location:
  • Phone: 844-215-7969
  • Fax: 406-758-7080
Mailing address:
  • Phone: 844-215-7969
  • Fax: 406-758-7080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberMED-NUTR-LIC-516
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: