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General NPI Number Information
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NPI Number | 1073165148
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Entity Type | Individual
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Provider Name | CHRYSTAL DANNETTE GUNN GAMMON NP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 2961 CROUSE LN
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City | BURLINGTON
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State | NC
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Zip | 27215-8833
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Country | US
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Telephone | 366-266-0518
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45
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City | SEDALIA
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State | NC
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Zip | 27342-0045
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Country | US
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Telephone | 434-429-2383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5012088
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | 5012088
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024177827
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License Number State | VA
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