Provider Demographics
NPI:1366644320
Name:TOPE, DAWN RENEE (FNP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:RENEE
Last Name:TOPE
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 1:17430 CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:MO
Mailing Address - Zip Code:65459-8245
Mailing Address - Country:US
Mailing Address - Phone:573-759-7363
Mailing Address - Fax:
Practice Address - Street 1:416 S BISHOP AVE
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-4311
Practice Address - Country:US
Practice Address - Phone:573-426-5900
Practice Address - Fax:573-426-4466
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO135472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily