Provider Demographics
NPI:1205035532
Name:OWEN, DAWN MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:OWEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 GRANT STREET
Mailing Address - Street 2:APT 1
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-1238
Mailing Address - Country:US
Mailing Address - Phone:508-567-1491
Mailing Address - Fax:
Practice Address - Street 1:155 GRANT STREET
Practice Address - Street 2:APT 1
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-1238
Practice Address - Country:US
Practice Address - Phone:508-567-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53261164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
0712698OtherMASS HEALTH PROVIDER NUMB