Provider Demographics
NPI:1235847500
Name:DAWES, DEBORAH (LPN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DAWES
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 1:135 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT EPHRAIM
Mailing Address - State:NJ
Mailing Address - Zip Code:08059-1615
Mailing Address - Country:US
Mailing Address - Phone:856-831-8375
Mailing Address - Fax:
Practice Address - Street 1:400 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08102-1526
Practice Address - Country:US
Practice Address - Phone:856-361-2700
Practice Address - Fax:856-541-4139
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06574400164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse