Provider Demographics
NPI:1043983810
Name:DUNNAHOO, FORREST CHADWICK (CRNA)
Entity Type:Individual
Prefix:
First Name:FORREST
Middle Name:CHADWICK
Last Name:DUNNAHOO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 FITCHIE PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6516
Mailing Address - Country:US
Mailing Address - Phone:509-990-6242
Mailing Address - Fax:
Practice Address - Street 1:134 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6523
Practice Address - Country:US
Practice Address - Phone:757-473-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC307968163W00000X
VA0024182621367500000X
NC6832367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse