Provider Demographics
NPI:1023536174
Name:DUNBAR, ELIZABETH HANKS (MP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HANKS
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 DURHAM RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ZAVALLA
Mailing Address - State:TX
Mailing Address - Zip Code:75980-4005
Mailing Address - Country:US
Mailing Address - Phone:910-723-7940
Mailing Address - Fax:
Practice Address - Street 1:3245 DURHAM RANCH RD
Practice Address - Street 2:
Practice Address - City:ZAVALLA
Practice Address - State:TX
Practice Address - Zip Code:75980-4005
Practice Address - Country:US
Practice Address - Phone:910-321-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009773363LF0000X
TX134066363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily