1194881300 NPI number — MRS. AURORA ACOSTA DUNN CRNP

Table of content: MRS. AURORA ACOSTA DUNN CRNP (NPI 1194881300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194881300 NPI number — MRS. AURORA ACOSTA DUNN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNN
Provider First Name:
AURORA
Provider Middle Name:
ACOSTA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194881300
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3810 SULLIVAN ST
Provider Second Line Business Mailing Address:
STE B
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35758-1789
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-461-8725
Provider Business Mailing Address Fax Number:
256-461-8725

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 WEST DUBLIN DR.
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35758-1787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-772-0606
Provider Business Practice Location Address Fax Number:
256-772-0676
Provider Enumeration Date:
12/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1-036879 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)