Provider Demographics
NPI:1508376484
Name:MAUNEY, LORENA DUNBAR (NP-C)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:DUNBAR
Last Name:MAUNEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4734 LONG BEACH RD SE
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-8721
Mailing Address - Country:US
Mailing Address - Phone:910-457-0070
Mailing Address - Fax:910-267-8936
Practice Address - Street 1:4734 LONG BEACH RD SE
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8721
Practice Address - Country:US
Practice Address - Phone:910-457-0070
Practice Address - Fax:910-267-8936
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009942363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner