MEDICARE: ROXANNE DUNN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.345020	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073549010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANNE DUNN RN

Provider Business Mailing Address
First Line	:	283 MOORES LN
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663-8923
Country	:	US
Telephone Number	:	740-858-2576
Fax Number	:	740-858-9416

Provider Business Practice Location Address
First Line	:	283 MOORES LN
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663-8923
Country	:	US
Telephone Number	:	740-858-2576
Fax Number	:	740-858-9416

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	10/20/2008

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