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General NPI Number Information
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NPI Number | 1649155920
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Entity Type | Individual
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Provider Name | LARRY ALTON GUNTER II CNS
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Gender | Male
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 100 BREWSTER BLVD
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City | CAMP LEJEUNE
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State | NC
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Zip | 28547-2575
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Country | US
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Telephone | 910-450-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 723 GREENWICH PL
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City | RICHLANDS
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State | NC
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Zip | 28574-1147
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Country | US
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Telephone | 757-749-6536
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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 | 364SC0200X
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Taxonomy Name | Critical Care Medicine Clinical Nurse Specialist
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License Number | 0024192683
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License Number State | VA
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