Provider Demographics
NPI:1639801566
Name:DAWOOD, PATRICIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:DAWOOD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 W 250 N STE 2
Mailing Address - Street 2:
Mailing Address - City:MARRIOTT SLATERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84404-9234
Mailing Address - Country:US
Mailing Address - Phone:801-600-3975
Mailing Address - Fax:
Practice Address - Street 1:1920 W 250 N STE 2
Practice Address - Street 2:
Practice Address - City:MARRIOTT SLATERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84404-9234
Practice Address - Country:US
Practice Address - Phone:801-600-3975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11288002-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner