Provider Demographics
NPI:1407281645
Name:DUNN, CAROLYN
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
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 1:4101 BERYL RD STE 230
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1002
Mailing Address - Country:US
Mailing Address - Phone:919-605-6169
Mailing Address - Fax:919-515-3483
Practice Address - Street 1:4101 BERYL RD STE 230
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1002
Practice Address - Country:US
Practice Address - Phone:919-605-6169
Practice Address - Fax:919-515-3483
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004020133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered