Provider Demographics
NPI:1699184945
Name:DUNN, KRISTINA LEIGH (ATC, EMT-B)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:LEIGH
Last Name:DUNN
Suffix:
Gender:F
Credentials:ATC, EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4776 E GUADALUPE RD APT 2045
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-7590
Mailing Address - Country:US
Mailing Address - Phone:317-691-2794
Mailing Address - Fax:
Practice Address - Street 1:4776 E GUADALUPE RD APT 2045
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-7590
Practice Address - Country:US
Practice Address - Phone:317-691-2794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN146N00000X
AZ11962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic