Provider Demographics
NPI:1851713093
Name:DUNLAP, CHARLOTTE JUANITA
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:JUANITA
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHARLOTTE
Other - Middle Name:JUANITA
Other - Last Name:LANCASTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1006 PASADENA AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2446
Mailing Address - Country:US
Mailing Address - Phone:256-320-5117
Mailing Address - Fax:
Practice Address - Street 1:1600 BROWNS FERRY RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9601
Practice Address - Country:US
Practice Address - Phone:256-461-5615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1037640364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health