Provider Demographics
NPI:1104689371
Name:GUNDERSON, ALANA (FNP-C)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:GUNDERSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 HORSECHESTNUT CT
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5309
Mailing Address - Country:US
Mailing Address - Phone:727-946-7586
Mailing Address - Fax:
Practice Address - Street 1:2044 TRINITY OAKS BLVD STE 210
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4406
Practice Address - Country:US
Practice Address - Phone:727-359-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily