Provider Demographics
NPI:1659336428
Name:FRIEDRICHSLPN, DAWN DOROTHEA (LPN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:DOROTHEA
Last Name:FRIEDRICHSLPN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BURDICK ST
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:WI
Mailing Address - Zip Code:53534-1729
Mailing Address - Country:US
Mailing Address - Phone:608-669-3159
Mailing Address - Fax:
Practice Address - Street 1:16 BURDICK ST
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-1729
Practice Address - Country:US
Practice Address - Phone:608-669-3159
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22984-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse