Provider Demographics
NPI:1336118348
Name:DUNN, SHARON GAIL (CFNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:GAIL
Last Name:DUNN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 HIGHWAY 35 S
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-6059
Mailing Address - Country:US
Mailing Address - Phone:601-937-0444
Mailing Address - Fax:601-937-0444
Practice Address - Street 1:1559 HIGHWAY 35 S
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-6059
Practice Address - Country:US
Practice Address - Phone:601-937-0444
Practice Address - Fax:601-937-0444
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR765273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS753068151005OtherTRICARE
MSP00021882OtherRR MEDICARE
MS168390705OtherUS DEPT OF LABOR
MS753068151Other1ST CHOICE
MS07226856Medicaid
MS753068151OtherMS PHYSICIANS CARE NETWOR
MS753068151OtherMS HEALTH PARTNERS
MS168390705OtherUS DEPT OF LABOR
MS500001361Medicare ID - Type Unspecified