Provider Demographics
NPI:1396808267
Name:DUNNING, KAREN (FNP-BC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DUNNING
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KOUTS
Mailing Address - State:IN
Mailing Address - Zip Code:46347-9692
Mailing Address - Country:US
Mailing Address - Phone:219-766-3131
Mailing Address - Fax:219-766-0303
Practice Address - Street 1:703 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KOUTS
Practice Address - State:IN
Practice Address - Zip Code:46347-9692
Practice Address - Country:US
Practice Address - Phone:219-766-3131
Practice Address - Fax:219-766-0303
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000497A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP0011476OtherRAILROAD PROVIDER NUMBER
IN000000329173OtherPROVIDER BCBS NUMBER
INP0011476OtherRAILROAD PROVIDER NUMBER
IN405160EEMedicare ID - Type UnspecifiedPROVIDER MEDICARE NUMBER