Provider Demographics
NPI:1780551499
Name:DUNNUM, DONTRICIA JEANTE (RN,CMLDT)
Entity type:Individual
Prefix:
First Name:DONTRICIA
Middle Name:JEANTE
Last Name:DUNNUM
Suffix:
Gender:F
Credentials:RN,CMLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 HANFRED LN STE 104
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4809
Mailing Address - Country:US
Mailing Address - Phone:404-829-0260
Mailing Address - Fax:
Practice Address - Street 1:2206 HANFRED LN STE 104
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4809
Practice Address - Country:US
Practice Address - Phone:404-829-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA233428163WM1400X, 163WS0121X, 163WG0000X, 163WE0003X
GA233243163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WE0003XNursing Service ProvidersRegistered NurseEmergency