Provider Demographics
NPI:1669628996
Name:GUNDERSON-FALCONE, GRACE (RN, MSN, A/GNP, FNP)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:GUNDERSON-FALCONE
Suffix:
Gender:F
Credentials:RN, MSN, A/GNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3309
Mailing Address - Street 2:DUKE UNIVERSITY MEDICAL CENTER
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702-3309
Mailing Address - Country:US
Mailing Address - Phone:919-684-3996
Mailing Address - Fax:919-681-7343
Practice Address - Street 1:DUKE UNIVERSITY MEDICAL CTR
Practice Address - Street 2:ECT PROGRAM DUMC BOX 3309, HOSPITAL SOUTH, TRENT AVE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-3996
Practice Address - Fax:919-681-7343
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC600081363L00000X, 363LA2200X, 363LG0600X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health