Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | RN247547 | GA |
NPI | 1003240813 |
---|---|
Provider Name | Carlee D Dunlap |
First Address | Richmond Hill, GA 31324-4872 |
Second Address | San Antonio, TX 78229-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2013 |
Last Update Date | 20/05/2015 |