Individual
IDA MARIE DUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 994-9326
(770) 994-4747
Mailing address
1837 JODECO RD, STOCKBRIDGE, GA 30281-5119
(770) 994-9326
(770) 994-4747
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN105176
GA
Other
Enumeration date
05/10/2006
Last updated
07/08/2007
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