Healthcare Provider Details

I. General information

NPI: 1174405518
Provider Name (Legal Business Name): LAURA J DUNN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 OCONEE SQUARE DR
SENECA SC
29678-2546
US

IV. Provider business mailing address

125 MAPLE ST APT 110
PENDLETON SC
29670-9220
US

V. Phone/Fax

Practice location:
  • Phone: 877-848-9810
  • Fax:
Mailing address:
  • Phone: 864-760-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number56886
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: