Provider Demographics
NPI:1629640776
Name:DAWSON, JENNIFER BETH (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BETH
Last Name:DAWSON
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 1:2649 160TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:IA
Mailing Address - Zip Code:52619-9661
Mailing Address - Country:US
Mailing Address - Phone:319-470-6150
Mailing Address - Fax:
Practice Address - Street 1:2649 160TH AVE
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:IA
Practice Address - Zip Code:52619-9661
Practice Address - Country:US
Practice Address - Phone:319-470-6150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082554163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty