Provider Demographics
NPI:1528015658
Name:JAMES, DAWN (CRNA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 ALBANY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62903-7646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 ALBANY RD
Practice Address - Street 2:SUITE C
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62903-7646
Practice Address - Country:US
Practice Address - Phone:618-457-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007498367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered