Provider Demographics
NPI:1689095515
Name:DUNN, TAMMY
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 KINKEAD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-1510
Mailing Address - Country:US
Mailing Address - Phone:479-218-8896
Mailing Address - Fax:
Practice Address - Street 1:5900 KINKEAD AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-1510
Practice Address - Country:US
Practice Address - Phone:479-218-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator