Basic Information
| Provider Information | |||||||||
| NPI: | 1417599606 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUNN | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LINN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 960 W MAGEE RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857044625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204050040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2355 N WYATT DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206164948 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2019 | ||||||||
| LastUpdateDate: | 10/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WD0400X | RN- | AZ | N | Nursing Service Providers | Registered Nurse | Diabetes Educator | 163WD0400X | RN128412 | AZ | Y | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No ID Information.