Provider Demographics
NPI:1548660616
Name:WHITE DUNIGAN, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:WHITE DUNIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 GROVE ST
Mailing Address - Street 2:APT A
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-3655
Mailing Address - Country:US
Mailing Address - Phone:704-936-6947
Mailing Address - Fax:
Practice Address - Street 1:3180 THOMASINA MCPHERSON BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8283
Practice Address - Country:US
Practice Address - Phone:843-745-2183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC214819163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse