Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP129832 | TX |
NPI | 1215302492 |
---|---|
Provider Name | Dawn Dunn |
First Address | Longview, TX 75601-5580 |
Second Address | Longview, TX 75601-5580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2015 |
Last Update Date | 14/12/2015 |