Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1088422 | AL |
NPI | 1043606577 |
---|---|
Provider Name | Terry Dunson |
First Address | Sandy, UT 84070-8760 |
Second Address | Selma, AL 36701-6748 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2015 |
Last Update Date | 10/04/2015 |