Provider Demographics
NPI:1922037431
Name:GARCIA, DAWN ANNETTE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ANNETTE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 24TH STREET
Mailing Address - Street 2:KENNER ARMY MEDICAL CLINIC
Mailing Address - City:FT GREGG-ADAMS
Mailing Address - State:VA
Mailing Address - Zip Code:23801
Mailing Address - Country:US
Mailing Address - Phone:602-718-5063
Mailing Address - Fax:
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:
Practice Address - City:FT GREGGADAMS
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:804-734-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6671363A00000X, 363A00000X
AZ7034950001332B00000X
AZ6748310001332B00000X
AZ7046960001332B00000X
AZ7045160001332B00000X
AZ7209350001332B00000X
AZ7047150001332B00000X
AZ7629170001332B00000X
NMPA2012-0044363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ05882Medicare UPIN