| Doctor Name: | MRS. STEFANIE LEE GUNN |
| NPI Number: | 1114166501 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 3821 |
| Business Practice Address: | 1 Wellness Blvd Suite 200 Irmo, SC - 290632871 |
| Business Phone Number: | 8037491111 |
| Business Fax Number: | 8037490050 |
| Mailing Address: | 1 Wellness Blvd, Suite 200 IRMO |
| State: | SC |
| Postal Code: | 290632871 |
| Phone Number: | 8037491111 |
| Fax Number: | 8037490050 |
| NPI Enumeration Date: | 02/10/2009 |
| NPI Last Update Date: | 08/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3821 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |