Basic Information
Provider Information
NPI: 1134202948
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUNNARSSON
FirstName: RANNVEIG
MiddleName: K
NamePrefix: MRS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10333 EL CAMINO REAL
Address2:  
City: ATASCADERO
State: CA
PostalCode: 934225808
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 10333 EL CAMINO REAL
Address2:  
City: ATASCADERO
State: CA
PostalCode: 934225808
CountryCode: US
TelephoneNumber: 8054682000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/23/2006
LastUpdateDate: 02/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X463002CAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X14791CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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