Individual
DONNA JEAN GUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 PETTIGREW ST, HENDERSON, NC 27536-4259
(252) 205-4325
Mailing address
320 PETTIGREW ST, HENDERSON, NC 27536-4259
(252) 205-4325
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
853256493
—
ND
Enumeration date
05/04/2022
Last updated
05/04/2022
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