Provider Demographics
NPI:1346762440
Name:DUNIVAN, KEVIN FRANKLIN (AGAC-NP)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:FRANKLIN
Last Name:DUNIVAN
Suffix:
Gender:M
Credentials:AGAC-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2219
Mailing Address - Country:US
Mailing Address - Phone:804-249-8888
Mailing Address - Fax:804-249-7246
Practice Address - Street 1:5901 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2219
Practice Address - Country:US
Practice Address - Phone:804-249-8888
Practice Address - Fax:804-249-7246
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175049363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care