Provider Demographics
NPI:1114181732
Name:DUNIGAN, MARY KATHERINE (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:DUNIGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KATHERINE
Other - Last Name:CULP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7049 COURTLY RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1659
Mailing Address - Country:US
Mailing Address - Phone:651-739-8393
Mailing Address - Fax:
Practice Address - Street 1:7049 COURTLY RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1659
Practice Address - Country:US
Practice Address - Phone:651-739-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-13
Last Update Date:2008-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR148260-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health