Provider Demographics
NPI:1659726107
Name:AUSTERMAN, DAWN
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:AUSTERMAN
Suffix:
Gender:F
Credentials:
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 8584
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-8584
Mailing Address - Country:US
Mailing Address - Phone:907-942-7302
Mailing Address - Fax:
Practice Address - Street 1:1912 MILL BAY RD LOT 4
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-6673
Practice Address - Country:US
Practice Address - Phone:907-942-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion