Individual
LATASHA ANN-PEGRAM DUNFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
500 RAY C HUNT DR FL 3, CHARLOTTESVILLE, VA 22903-2981
(434) 924-2224
(434) 982-3652
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0024175048
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
0024175048
VA
Other
Enumeration date
08/28/2017
Last updated
03/08/2019
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