Provider Demographics
NPI:1407457765
Name:DUNBAR, KALEISHA DANYELLE
Entity Type:Individual
Prefix:
First Name:KALEISHA
Middle Name:DANYELLE
Last Name:DUNBAR
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 1:8143 IRIS RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4276
Mailing Address - Country:US
Mailing Address - Phone:423-771-7539
Mailing Address - Fax:
Practice Address - Street 1:8143 IRIS RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4276
Practice Address - Country:US
Practice Address - Phone:423-771-7539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle