Provider Demographics
NPI:1639653116
Name:GUNN, VARINA S
Entity type:Individual
Prefix:
First Name:VARINA
Middle Name:S
Last Name:GUNN
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 1:335R PRARIE AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-444-8069
Mailing Address - Fax:401-444-8061
Practice Address - Street 1:335R PRARIE AVE.
Practice Address - Street 2:SUITE 2B
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-444-8069
Practice Address - Fax:401-444-8069
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator