Provider Demographics
NPI:1407067408
Name:GATES, DAWN MARIE (RN,BSN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:GATES
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:URBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,BSN
Mailing Address - Street 1:4814 HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-6987
Mailing Address - Country:US
Mailing Address - Phone:605-721-9991
Mailing Address - Fax:
Practice Address - Street 1:1121 WASHINGTON BLVD
Practice Address - Street 2:WESTON COUNTY HEALTH SERVICE
Practice Address - City:NEWCASTLE
Practice Address - State:WY
Practice Address - Zip Code:82701
Practice Address - Country:US
Practice Address - Phone:307-746-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR026320163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse