Provider Demographics
NPI:1245571157
Name:DUNAGAN, ALEISHA (NP)
Entity type:Individual
Prefix:
First Name:ALEISHA
Middle Name:
Last Name:DUNAGAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 SUMMITT
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-0102
Mailing Address - Country:US
Mailing Address - Phone:205-287-7555
Mailing Address - Fax:205-384-9006
Practice Address - Street 1:6610 CURRY HWY
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35503-5664
Practice Address - Country:US
Practice Address - Phone:205-295-2020
Practice Address - Fax:205-295-2099
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily