Provider Demographics
NPI:1134875628
Name:DUNN, KERRY ANN
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:ANN
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 1:1941 FORANE ST
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-5724
Mailing Address - Country:US
Mailing Address - Phone:760-792-6929
Mailing Address - Fax:
Practice Address - Street 1:480 ARMORY RD
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-4932
Practice Address - Country:US
Practice Address - Phone:760-252-7357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider