Provider Demographics
NPI:1609246198
Name:DUNNIGAN, LINDA M (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:DUNNIGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MINTO
Mailing Address - State:ND
Mailing Address - Zip Code:58261-6165
Mailing Address - Country:US
Mailing Address - Phone:701-360-0389
Mailing Address - Fax:701-248-3652
Practice Address - Street 1:1599 J ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS AFB
Practice Address - State:ND
Practice Address - Zip Code:58205-6306
Practice Address - Country:US
Practice Address - Phone:701-747-5601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR 18283163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse