Provider Demographics
NPI:1770650152
Name:LEGGON, DAWN WHITE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:WHITE
Last Name:LEGGON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:OUELLETTE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:10000 W COLONIAL DR STE 184
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3434
Mailing Address - Country:US
Mailing Address - Phone:407-296-1923
Mailing Address - Fax:407-636-7850
Practice Address - Street 1:10000 W COLONIAL DR STE 184
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3434
Practice Address - Country:US
Practice Address - Phone:407-296-1923
Practice Address - Fax:407-636-7850
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3195492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP88188Medicare UPIN