Provider Demographics
NPI:1033829668
Name:FIELDS, DAWN RECHELE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:RECHELE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 STATE PARK RD
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-5206
Mailing Address - Country:US
Mailing Address - Phone:405-831-5434
Mailing Address - Fax:
Practice Address - Street 1:800 STATE PARK RD
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-5206
Practice Address - Country:US
Practice Address - Phone:405-831-5434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider