Provider Demographics
NPI:1063042257
Name:CRIST, DAWN
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:CRIST
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 1:3515 LOW LN
Mailing Address - Street 2:
Mailing Address - City:TODDVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52341-9629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3515 LOW LN
Practice Address - Street 2:
Practice Address - City:TODDVILLE
Practice Address - State:IA
Practice Address - Zip Code:52341-9629
Practice Address - Country:US
Practice Address - Phone:319-330-2539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay