Provider Demographics
NPI:1043280639
Name:SPOSATO, DAWN M (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:SPOSATO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:BOATWRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:909 SW ORALABOR RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7004
Mailing Address - Country:US
Mailing Address - Phone:515-965-0300
Mailing Address - Fax:515-471-9319
Practice Address - Street 1:909 SW ORALABOR RD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7004
Practice Address - Country:US
Practice Address - Phone:515-965-0300
Practice Address - Fax:515-471-9319
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA103607363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA10043280639Medicaid
I16097Medicare ID - Type Unspecified
IA10043280639Medicaid
IA71926070Medicare PIN