Provider Demographics
NPI:1811186893
Name:DUNAWAY, CARLA S (APRN BC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:S
Last Name:DUNAWAY
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Gender:F
Credentials:APRN BC
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Mailing Address - Street 1:600 SUNCREST TOWNE CENTRE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1872
Mailing Address - Country:US
Mailing Address - Phone:304-598-2200
Mailing Address - Fax:304-599-2674
Practice Address - Street 1:600 SUNCREST TOWNE CENTRE
Practice Address - Street 2:SUITE 310
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1872
Practice Address - Country:US
Practice Address - Phone:304-598-2200
Practice Address - Fax:304-599-2674
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2021-07-06
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Provider Licenses
StateLicense IDTaxonomies
WV30709363LA2100X
PARN567961363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVNP25921Medicare UPIN