Provider Demographics
NPI:1619268190
Name:WILLIAMS, DAWN LYNN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748860
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-4617
Mailing Address - Country:US
Mailing Address - Phone:480-497-2229
Mailing Address - Fax:480-699-5681
Practice Address - Street 1:4540 E BASELINE RD SUITE 114
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-497-2229
Practice Address - Fax:480-699-5681
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN064029363L00000X
AZAP6992363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN064029OtherREGISTERED NURSE LICENSE NUMBER