Provider Demographics
NPI:1457824922
Name:DUNN, KIM ELIZABETH (HHA)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:ELIZABETH
Last Name:DUNN
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 DUKE ST APT A3
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2538
Mailing Address - Country:US
Mailing Address - Phone:301-537-8091
Mailing Address - Fax:
Practice Address - Street 1:4335 DUKE ST APT A3
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2538
Practice Address - Country:US
Practice Address - Phone:301-537-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide