Provider Demographics
NPI:1093462343
Name:SMITH-JOHNSON, DAWN (RN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SMITH-JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3764
Mailing Address - Country:US
Mailing Address - Phone:225-256-6604
Mailing Address - Fax:
Practice Address - Street 1:3455 FLORIDA ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3764
Practice Address - Country:US
Practice Address - Phone:225-256-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN114841163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse