Provider Demographics
NPI:1073815684
Name:FIELDS, DAWN MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:830 PENNSYLVANIA AVE 201
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3389
Mailing Address - Country:US
Mailing Address - Phone:304-388-6950
Mailing Address - Fax:304-388-6955
Practice Address - Street 1:415 MORRIS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1842
Practice Address - Country:US
Practice Address - Phone:304-388-6441
Practice Address - Fax:304-388-6445
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV44253363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FINP39691Medicare PIN