Provider Demographics
NPI:1003178096
Name:ALLEN, DAWN M (RN)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:15481 W CLUB DELUXE RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1466
Mailing Address - Country:US
Mailing Address - Phone:985-543-4165
Mailing Address - Fax:985-543-4037
Practice Address - Street 1:15481 W CLUB DELUXE RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1466
Practice Address - Country:US
Practice Address - Phone:985-543-4165
Practice Address - Fax:985-543-4037
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN081120163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health