Provider Demographics
NPI:1497299242
Name:SPECHT, DAWN (APN, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SPECHT
Suffix:
Gender:F
Credentials:APN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:ERIAL
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-2312
Mailing Address - Country:US
Mailing Address - Phone:856-784-5056
Mailing Address - Fax:
Practice Address - Street 1:114 MONTICELLO DR
Practice Address - Street 2:
Practice Address - City:ERIAL
Practice Address - State:NJ
Practice Address - Zip Code:08081-2312
Practice Address - Country:US
Practice Address - Phone:856-784-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC08262400363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care