Provider Demographics
NPI:1881456044
Name:DUNNING, MADISON JADE (CRNA)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:JADE
Last Name:DUNNING
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:JADE
Other - Last Name:GUTHRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8915 HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-9303
Mailing Address - Country:US
Mailing Address - Phone:530-713-4451
Mailing Address - Fax:
Practice Address - Street 1:1530 LONE OAK RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7901
Practice Address - Country:US
Practice Address - Phone:270-444-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4015263367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered