Provider Demographics
NPI:1003132515
Name:MYKEL, DAWN M (LPN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:MYKEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:GUARASCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-1810
Mailing Address - Country:US
Mailing Address - Phone:315-520-6390
Mailing Address - Fax:315-520-6390
Practice Address - Street 1:6 HIGH ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:NY
Practice Address - Zip Code:13492-1810
Practice Address - Country:US
Practice Address - Phone:315-520-6390
Practice Address - Fax:315-520-6390
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293254-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse