Provider Demographics
NPI:1992496087
Name:GUNN, DANA CAROL (RN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:CAROL
Last Name:GUNN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7631B RICHMOND HWY
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522-8679
Mailing Address - Country:US
Mailing Address - Phone:804-869-5045
Mailing Address - Fax:434-664-1377
Practice Address - Street 1:7631B RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522-8679
Practice Address - Country:US
Practice Address - Phone:804-869-5045
Practice Address - Fax:434-664-1377
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001180744163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty