Provider Demographics
NPI:1700123437
Name:DUNN, ADRIAN LYNN (CRNA)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:LYNN
Last Name:DUNN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15483 SUMAC RD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:MO
Mailing Address - Zip Code:64755-7239
Mailing Address - Country:US
Mailing Address - Phone:417-629-4689
Mailing Address - Fax:
Practice Address - Street 1:100 N PINE ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-4756
Practice Address - Country:US
Practice Address - Phone:620-231-9072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013001156367500000X
TX91183367500000X
KS43-557396367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered