Provider Demographics
NPI:1164003513
Name:DUNN, VIKKI (RN)
Entity Type:Individual
Prefix:
First Name:VIKKI
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 1:3538 BLAKE RD
Mailing Address - Street 2:
Mailing Address - City:SEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44273-8932
Mailing Address - Country:US
Mailing Address - Phone:330-421-3911
Mailing Address - Fax:
Practice Address - Street 1:780 HIGH ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-1610
Practice Address - Country:US
Practice Address - Phone:330-336-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.265847163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN.265847OtherOHIO STATE BOARD OF NURSING