Provider Demographics
NPI:1538250360
Name:DUNN, PATRICIA LAUBACH (ARNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LAUBACH
Last Name:DUNN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 N COURTENAY PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4852
Mailing Address - Country:US
Mailing Address - Phone:321-784-8211
Mailing Address - Fax:321-394-9425
Practice Address - Street 1:595 N COURTENAY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4852
Practice Address - Country:US
Practice Address - Phone:321-784-8211
Practice Address - Fax:321-394-9425
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1242902163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 1242902OtherSTATE LICENSE NUMBER
FLARNP 1242902OtherSTATE LICENSE NUMBER