Provider Demographics
NPI:1326410689
Name:CORRIERE, DAWN THERESA (CNM)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:THERESA
Last Name:CORRIERE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 INGERSOLL AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-3411
Mailing Address - Country:US
Mailing Address - Phone:515-309-6011
Mailing Address - Fax:515-309-3014
Practice Address - Street 1:3714 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312
Practice Address - Country:US
Practice Address - Phone:515-309-6011
Practice Address - Fax:515-309-3014
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAB151052367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife