Provider Demographics
NPI:1477951515
Name:GULLEY, TAUNA (PHD, FNP, MSN)
Entity Type:Individual
Prefix:DR
First Name:TAUNA
Middle Name:
Last Name:GULLEY
Suffix:
Gender:F
Credentials:PHD, FNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 7070
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293
Mailing Address - Country:US
Mailing Address - Phone:276-328-8850
Mailing Address - Fax:276-328-8853
Practice Address - Street 1:233 CHASE STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228
Practice Address - Country:US
Practice Address - Phone:276-328-8850
Practice Address - Fax:276-328-8853
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024128995363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health