Provider Demographics
NPI:1578033304
Name:ROSE-ALLEN, DAWNITA (LPN)
Entity Type:Individual
Prefix:
First Name:DAWNITA
Middle Name:
Last Name:ROSE-ALLEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 REMINGTON CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8274
Mailing Address - Country:US
Mailing Address - Phone:501-850-8788
Mailing Address - Fax:501-850-8791
Practice Address - Street 1:5 REMINGTON CV
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-8274
Practice Address - Country:US
Practice Address - Phone:501-850-8788
Practice Address - Fax:501-850-8791
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL053659164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse