Provider Demographics
NPI:1083486872
Name:NORDQUIST, DAWN LEIGH (CNM)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:LEIGH
Last Name:NORDQUIST
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 GROUSE RD
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-6127
Mailing Address - Country:US
Mailing Address - Phone:605-280-3940
Mailing Address - Fax:
Practice Address - Street 1:124 GROUSE RD
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-6127
Practice Address - Country:US
Practice Address - Phone:605-280-3940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCM000108367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife