Provider Demographics
NPI:1679267298
Name:VILLARS, DAWN D
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:D
Last Name:VILLARS
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 1:228 1ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5608
Mailing Address - Country:US
Mailing Address - Phone:701-290-0099
Mailing Address - Fax:
Practice Address - Street 1:228 1ST AVE SE
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5608
Practice Address - Country:US
Practice Address - Phone:701-290-0099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIL-81-1537374U00000X
NDVIL-81-1537251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide