Provider Demographics
NPI:1366827784
Name:PANKEY, DAWN (RN,CCM)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:PANKEY
Suffix:
Gender:F
Credentials:RN,CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5913
Mailing Address - Country:US
Mailing Address - Phone:917-843-3631
Mailing Address - Fax:
Practice Address - Street 1:767 E 52ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5913
Practice Address - Country:US
Practice Address - Phone:917-843-3631
Practice Address - Fax:718-451-2062
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY371260163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management