Provider Demographics
NPI:1598378028
Name:DENNIS, DAWN RENEE (RN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:RENEE
Last Name:DENNIS
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 1:20 ADOBE CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-5526
Mailing Address - Country:US
Mailing Address - Phone:732-962-3973
Mailing Address - Fax:
Practice Address - Street 1:2012 EASTVIEW PKWY
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-5701
Practice Address - Country:US
Practice Address - Phone:770-679-0586
Practice Address - Fax:770-285-6325
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN282103163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse