Provider Demographics
NPI:1073631909
Name:PENDER, DAWN ELIZABETH (APRN-BC)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ELIZABETH
Last Name:PENDER
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 MIDDLEBURG DR SUITE 111
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204
Mailing Address - Country:US
Mailing Address - Phone:803-414-0595
Mailing Address - Fax:803-227-8806
Practice Address - Street 1:2711 MIDDLEBURG DR SUITE 111
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204
Practice Address - Country:US
Practice Address - Phone:803-414-0595
Practice Address - Fax:803-227-8806
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3109363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner