Provider Demographics
NPI:1134682628
Name:DAWSON, TAMMY (PMHNP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3124 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1100
Mailing Address - Country:US
Mailing Address - Phone:724-856-8620
Mailing Address - Fax:
Practice Address - Street 1:3124 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1100
Practice Address - Country:US
Practice Address - Phone:724-856-8620
Practice Address - Fax:724-856-3929
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020180363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health