Provider Demographics
NPI:1790315216
Name:DUNN, CAROLINE COOPER
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:COOPER
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 1:2029 S COLLEGE ST APT 43B
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-5893
Mailing Address - Country:US
Mailing Address - Phone:334-303-0055
Mailing Address - Fax:
Practice Address - Street 1:2029 S COLLEGE ST APT 43B
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-5893
Practice Address - Country:US
Practice Address - Phone:334-303-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS12719390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program