Provider Demographics
NPI:1821397381
Name:RAGO-ROSE, DAWN (MSN,RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:RAGO-ROSE
Suffix:
Gender:F
Credentials:MSN,RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4618 FOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1977
Mailing Address - Country:US
Mailing Address - Phone:323-953-7170
Mailing Address - Fax:
Practice Address - Street 1:3800 KILROY AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2494
Practice Address - Country:US
Practice Address - Phone:855-667-7226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2021-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17723363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily