Provider Demographics
NPI:1346319282
Name:HARRISON, DAWN SAUTTERS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:SAUTTERS
Last Name:HARRISON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 MEDICAL CAMPUS DR NW STE 102
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-4093
Practice Address - Country:US
Practice Address - Phone:910-754-5988
Practice Address - Fax:910-754-5989
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39999363LF0000X
FLAPRN11018011363LF0000X
NC201372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC7992AOtherMEDICARE PTAN
NC2802727Medicare ID - Type Unspecified
NCNC7992AOtherMEDICARE PTAN