Provider Demographics
NPI:1225426927
Name:DUNN, KRISTINA
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14209 COOK RD, SUITE 200
Mailing Address - Street 2:MEMORIAL PHYSICIAN CLINICS -NEURO AND SPINE
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:35932
Mailing Address - Country:US
Mailing Address - Phone:228-575-2536
Mailing Address - Fax:228-872-0559
Practice Address - Street 1:14209 COOK RD, SUITE 200
Practice Address - Street 2:MEMORIAL PHYSICIAN CLINICS -NEURO AND SPINE
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:35932
Practice Address - Country:US
Practice Address - Phone:228-575-2536
Practice Address - Fax:228-872-0559
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-03
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR888426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily