Provider Demographics
NPI:1417253204
Name:DAWSON, ROBIN PEACOCK (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:PEACOCK
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:LEAR
Other - Last Name:PEACOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2808 MCLAMB PL
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1600
Practice Address - Country:US
Practice Address - Phone:919-736-2157
Practice Address - Fax:919-587-0790
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02742363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical