Provider Demographics
NPI:1154667202
Name:DUNN, LAURA ANITA (APRN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANITA
Last Name:DUNN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 FIRE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:ELLERBE
Mailing Address - State:NC
Mailing Address - Zip Code:28338-9017
Mailing Address - Country:US
Mailing Address - Phone:910-817-8562
Mailing Address - Fax:803-329-1918
Practice Address - Street 1:452 LAKESHORE PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4291
Practice Address - Country:US
Practice Address - Phone:803-329-1915
Practice Address - Fax:803-329-1918
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18074364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult