Provider Demographics
NPI:1225692353
Name:DAWSON, LILWANDA ARLENA (CNA)
Entity Type:Individual
Prefix:
First Name:LILWANDA
Middle Name:ARLENA
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3744 IMPERIAL DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-5078
Mailing Address - Country:US
Mailing Address - Phone:863-589-2037
Mailing Address - Fax:
Practice Address - Street 1:3744 IMPERIAL DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-5078
Practice Address - Country:US
Practice Address - Phone:863-589-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health