MEDICARE: ANGEL DUNN

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	251E00000X	Home Health Agency
2	313M00000X	Nursing Facility/Intermediate Care Facility

General Provider Information

NPI Number	:	1295441855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL DUNN

Provider Business Mailing Address
First Line	:	2620 RICHMOND HILL RD
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30906-2881
Country	:	US
Telephone Number	:	706-877-1619
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 RICHMOND HILL RD
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30906-2881
Country	:	US
Telephone Number	:	706-877-1619
Fax Number	:

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

Provider Enumeration Date	:	01/26/2023
Last Update Date	:	01/26/2023

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Directions to “ ANGEL DUNN ” Practice Location

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