Provider Demographics
NPI:1891466801
Name:DAWKINS, ELIZABETH PADEN-WALKER (FNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PADEN-WALKER
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 COTTON DR
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38756-3308
Mailing Address - Country:US
Mailing Address - Phone:662-822-0363
Mailing Address - Fax:
Practice Address - Street 1:1687 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-7326
Practice Address - Country:US
Practice Address - Phone:312-219-1224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily