Provider Demographics
NPI:1639769805
Name:DUNNING, KIRSTEN LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LYNN
Last Name:DUNNING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15511 N FLORIDA AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1220
Mailing Address - Country:US
Mailing Address - Phone:813-963-3124
Mailing Address - Fax:
Practice Address - Street 1:15511 N FLORIDA AVE STE 401
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1220
Practice Address - Country:US
Practice Address - Phone:813-963-3124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11010715363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily