Provider Demographics
NPI:1437604881
Name:GUNSON, ROSALIE MARIE (NP)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:MARIE
Last Name:GUNSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ROSALIE
Other - Middle Name:MARIE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:200 EXECUTIVE CENTER PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3177
Mailing Address - Country:US
Mailing Address - Phone:405-779-0132
Mailing Address - Fax:
Practice Address - Street 1:200 EXECUTIVE CENTER PKWY STE 102
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3177
Practice Address - Country:US
Practice Address - Phone:405-779-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421247363LW0102X
VA0024176406363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health