Provider Demographics
NPI:1265106611
Name:GUNNER, ELIZABETH MR (RDN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MR
Last Name:GUNNER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 WILKINS TRACT
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14487-9648
Mailing Address - Country:US
Mailing Address - Phone:585-519-3399
Mailing Address - Fax:
Practice Address - Street 1:6209 WILKINS TRACT
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:NY
Practice Address - Zip Code:14487-9648
Practice Address - Country:US
Practice Address - Phone:585-519-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-08
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty