Provider Demographics
NPI:1518343979
Name:GUNN, KELLI (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:KELLI
Middle Name:
Last Name:GUNN
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 MOUNT RUSHMORE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4726
Mailing Address - Country:US
Mailing Address - Phone:605-416-9930
Mailing Address - Fax:605-416-9931
Practice Address - Street 1:2006 MOUNT RUSHMORE RD STE 2
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4726
Practice Address - Country:US
Practice Address - Phone:605-416-9930
Practice Address - Fax:605-416-9931
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002500363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily