Individual
STACEY L DUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
Mailing address
57 ALTON ST, WALPOLE, MA 02081-4101
(413) 297-0237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00872
RI
363A00000X
Physician Assistant
PA6561
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110136606A
—
MA
Enumeration date
05/31/2009
Last updated
02/11/2026
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