Provider Demographics
NPI:1417497553
Name:ATUGONZA, DAWN
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:ATUGONZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6864 WESTWYCK DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43571-9266
Mailing Address - Country:US
Mailing Address - Phone:419-708-8364
Mailing Address - Fax:
Practice Address - Street 1:6864 WESTWYCK DR
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:OH
Practice Address - Zip Code:43571-9266
Practice Address - Country:US
Practice Address - Phone:419-708-8364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401152971010374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide