Provider Demographics
NPI:1073549010
Name:DUNN, ROXANNE (RN)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 MOORES LN
Mailing Address - Street 2:
Mailing Address - City:WEST PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45663-8923
Mailing Address - Country:US
Mailing Address - Phone:740-858-2576
Mailing Address - Fax:740-858-9416
Practice Address - Street 1:283 MOORES LN
Practice Address - Street 2:
Practice Address - City:WEST PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45663-8923
Practice Address - Country:US
Practice Address - Phone:740-858-2576
Practice Address - Fax:740-858-9416
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.345020163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2099438Medicaid