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General NPI Number Information
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NPI Number | 1558321935
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Entity Type | Individual
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Provider Name | RICHARD THOMAS GUNN NP
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 1135 MORTON ST
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City | MATTAPAN
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State | MA
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Zip | 02126-2834
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Country | US
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Telephone | 617-533-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 22 TEMPLE RD
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City | MARSHFIELD
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State | MA
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Zip | 02050-5348
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Country | US
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Telephone | 508-367-2702
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 208760
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License Number State | MA
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