MEDICARE: CARRIE GUNN

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	163WS0200X	School Registered Nurse	522034	NY

General Provider Information

NPI Number	:	1508134446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE GUNN

Provider Business Mailing Address
First Line	:	99 MYERS CORNERS RD
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-3211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 MYERS CORNERS RD
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-3211
Country	:	US
Telephone Number	:	845-298-5100
Fax Number	:

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

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	01/10/2020

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