Healthcare Provider Details

I. General information

NPI: 1861306029
Provider Name (Legal Business Name): ANNA LEE DUNDORF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNA LEE NEDROW

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MEMORIAL DR
PINEHURST NC
28374-8710
US

IV. Provider business mailing address

270 MADDOX DR
ABERDEEN NC
28315-5005
US

V. Phone/Fax

Practice location:
  • Phone: 910-715-1000
  • Fax:
Mailing address:
  • Phone: 704-776-3190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1110463
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: