Provider Demographics
NPI:1801645544
Name:DUNN, ANEISHA DIANA (RN)
Entity type:Individual
Prefix:
First Name:ANEISHA
Middle Name:DIANA
Last Name:DUNN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 AVENUE I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4403
Mailing Address - Country:US
Mailing Address - Phone:917-862-5215
Mailing Address - Fax:718-347-4643
Practice Address - Street 1:3819 AVENUE I
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4403
Practice Address - Country:US
Practice Address - Phone:917-862-5215
Practice Address - Fax:718-347-4643
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY766796163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse