Provider Demographics
NPI:1194954933
Name:DUNLAP, BRIAN (CRNA)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:12 ST PAUL DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1035
Practice Address - Country:US
Practice Address - Phone:717-217-6072
Practice Address - Fax:717-217-6952
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN322961L367500000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102417342Medicaid
11985589OtherCAQH
PA25-1716306OtherHEALTHNET/TRICARE
PAP00795878OtherRAILROAD MEDICARE
PARN322961LOtherLICENSE
PA1007307260035OtherMEDICAID GROUP #
PAG920-0134/85XWCUOtherCAREFIRST
PA050514OtherMEDICARE GROUP #
PAP00795878OtherRAILROAD MEDICARE
PA102417342 0001Medicaid