Provider Demographics
NPI:1558920793
Name:DAWSON, LANITA RENEE (BSN,RN)
Entity Type:Individual
Prefix:MS
First Name:LANITA
Middle Name:RENEE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 SOHO ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1969
Mailing Address - Country:US
Mailing Address - Phone:803-448-5041
Mailing Address - Fax:
Practice Address - Street 1:724 SOHO ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-1969
Practice Address - Country:US
Practice Address - Phone:803-448-5041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant