Healthcare Provider Details

I. General information

NPI: 1023841095
Provider Name (Legal Business Name): MICHELLE ANN DUNSTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE ANN IRVING

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 GARDEN LAKE PKWY
TOLEDO OH
43614-2779
US

IV. Provider business mailing address

2921 MIDWOOD AVE
TOLEDO OH
43606-3811
US

V. Phone/Fax

Practice location:
  • Phone: 419-381-0037
  • Fax:
Mailing address:
  • Phone: 419-944-9884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number313192
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: