Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 5014208 | NC |
NPI | 1083206734 |
---|---|
Provider Name | Emily Dunn |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28207-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2021 |
Last Update Date | 08/02/2022 |