Provider Demographics
NPI:1952806101
Name:DUNNAHOE, CHARLES ROBERT (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:ROBERT
Last Name:DUNNAHOE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S BEATON ST
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-5230
Mailing Address - Country:US
Mailing Address - Phone:903-602-5009
Mailing Address - Fax:903-602-5039
Practice Address - Street 1:106 S BEATON ST
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5230
Practice Address - Country:US
Practice Address - Phone:903-602-5009
Practice Address - Fax:903-602-5039
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137194363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily