Provider Demographics
NPI:1396578704
Name:GUNN, JULIANA DYESS (APRN)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:DYESS
Last Name:GUNN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10705 MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:LILLIAN
Mailing Address - State:AL
Mailing Address - Zip Code:36549-5578
Mailing Address - Country:US
Mailing Address - Phone:251-242-1312
Mailing Address - Fax:
Practice Address - Street 1:6883 US HIGHWAY 90 STE 108
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9611
Practice Address - Country:US
Practice Address - Phone:251-318-2601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-163234363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics