Individual
SHANE PAUL DUNAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
24 PHYSICIANS DR, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Mailing address
24 PHYSICIANS DR, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
25357
TN
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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