Basic Information
| Provider Information | |||||||||
| NPI: | 1619382918 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | DIANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 280 BALTIMORE CHURCH RD | ||||||||
| Address2: | |||||||||
| City: | MAYFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420668109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708041918 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 S 12TH ST | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420719303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707599200 | ||||||||
| FaxNumber: | 2707599966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2014 | ||||||||
| LastUpdateDate: | 03/29/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA1896 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.