MEDICARE: MS. DEE GUNDERSON M.S.N., A.P.N

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN0000010439	TN

General Provider Information

NPI Number	:	1508068925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEE GUNDERSON M.S.N., A.P.N

Provider Business Mailing Address
First Line	:	1404 MARRIMANS CT
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-8576
Country	:	US
Telephone Number	:	805-714-9849
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 MARRIMANS CT
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-8576
Country	:	US
Telephone Number	:	805-714-9849
Fax Number	:

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

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	07/08/2007

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