Healthcare Provider Details

I. General information

NPI: 1184996910
Provider Name (Legal Business Name): GRETA DUNN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CVHS - CHARLOTTE 165 LEGRANDE AVE
CHARLOTTE COURTHOUSE VA
23923
US

IV. Provider business mailing address

165 LEGRANDE AVE
CHARLOTTE COURT HOUSE VA
23923-3747
US

V. Phone/Fax

Practice location:
  • Phone: 434-542-5560
  • Fax:
Mailing address:
  • Phone: 434-542-5560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024169821
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: