Basic Information
| Provider Information | |||||||||
| NPI: | 1245595404 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUNN | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | OLIVIA | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 E 3RD ST | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374032241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237788837 | ||||||||
| FaxNumber: | 4237789301 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 E 3RD ST | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374032241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237788837 | ||||||||
| FaxNumber: | 4237789301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2012 | ||||||||
| LastUpdateDate: | 12/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 12/10/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 3604 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3604 | 01 | TN | STATE MEDICAL LICENSE | OTHER |