Provider Demographics
NPI:1770677494
Name:DUNSCOMBE, ALTHEA R (RN, PHD, CRNFA, LNC)
Entity Type:Individual
Prefix:MS
First Name:ALTHEA
Middle Name:R
Last Name:DUNSCOMBE
Suffix:
Gender:F
Credentials:RN, PHD, CRNFA, LNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 SW 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4712
Mailing Address - Country:US
Mailing Address - Phone:352-332-8655
Mailing Address - Fax:
Practice Address - Street 1:8001 SW 30TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4712
Practice Address - Country:US
Practice Address - Phone:352-332-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1118942163WR0006X
NH022423-21163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY3602OtherBLUE CROSS BLUE SHIELD