Provider Demographics
NPI:1518229301
Name:HARLICK, DAWN MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:HARLICK
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 1:30800 TELEGRAPH RD
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4542
Mailing Address - Country:US
Mailing Address - Phone:248-593-0100
Mailing Address - Fax:248-593-0175
Practice Address - Street 1:30800 TELEGRAPH RD
Practice Address - Street 2:SUITE 2800
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4542
Practice Address - Country:US
Practice Address - Phone:248-593-0100
Practice Address - Fax:248-593-0175
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704231034163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse