Provider Demographics
NPI:1679073373
Name:DUSHANE, DAWN MARIE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:DUSHANE
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 1:1303 ROBYN LN
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-3279
Mailing Address - Country:US
Mailing Address - Phone:903-253-3720
Mailing Address - Fax:
Practice Address - Street 1:1303 ROBYN LN
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-3279
Practice Address - Country:US
Practice Address - Phone:903-253-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
1068934OtherHOME HEALTH PROVIDER