Provider Demographics
NPI:1447386446
Name:GUNN, AMANDA NELL (CRNA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:NELL
Last Name:GUNN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2651
Mailing Address - Country:US
Mailing Address - Phone:615-406-5416
Mailing Address - Fax:
Practice Address - Street 1:2 GREENWAY PLZ STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046-0207
Practice Address - Country:US
Practice Address - Phone:832-828-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12414367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered