Provider Demographics
NPI:1639534670
Name:DAWSON, MARGARET ROSE (CNS)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ROSE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3038 W 850 S
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:IN
Mailing Address - Zip Code:46914-9810
Mailing Address - Country:US
Mailing Address - Phone:765-689-8920
Mailing Address - Fax:
Practice Address - Street 1:3038 W 850 S
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:IN
Practice Address - Zip Code:46914-9810
Practice Address - Country:US
Practice Address - Phone:765-689-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV28095438A364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult