Provider Demographics
NPI:1417609363
Name:VERMILYA, DAWN (RN)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:VERMILYA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 E HAMPTON AVE UNIT 76
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-6436
Mailing Address - Country:US
Mailing Address - Phone:951-776-7573
Mailing Address - Fax:
Practice Address - Street 1:10211 E MADERO AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-1493
Practice Address - Country:US
Practice Address - Phone:480-635-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTEMP267328163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool