Healthcare Provider Details

I. General information

NPI: 1508885831
Provider Name (Legal Business Name): DEBORA KAY DUNN L.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1143 HOLLANDER ST APT 1
NEWARK OH
43055-6066
US

IV. Provider business mailing address

1143 HOLLANDER ST APT 1
NEWARK OH
43055-6066
US

V. Phone/Fax

Practice location:
  • Phone: 740-334-7246
  • Fax:
Mailing address:
  • Phone: 740-334-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN101749
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: