Provider Demographics
NPI:1639784531
Name:GUNN, DEBRA LYNN
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
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 1:50 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04429-7152
Mailing Address - Country:US
Mailing Address - Phone:207-745-0013
Mailing Address - Fax:
Practice Address - Street 1:50 CHURCH RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:ME
Practice Address - Zip Code:04429-7152
Practice Address - Country:US
Practice Address - Phone:207-745-0013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer