Provider Demographics
NPI:1710584123
Name:HUNKLER, DAWN
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:HUNKLER
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:PO BOX 77
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:OH
Mailing Address - Zip Code:45360-0077
Mailing Address - Country:US
Mailing Address - Phone:937-538-8670
Mailing Address - Fax:
Practice Address - Street 1:535 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:OH
Practice Address - Zip Code:45360
Practice Address - Country:US
Practice Address - Phone:937-538-8670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide