Provider Demographics
NPI:1962376566
Name:DAWSON, DOTIANA MARNISE
Entity type:Individual
Prefix:
First Name:DOTIANA
Middle Name:MARNISE
Last Name:DAWSON
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 1:1705 S PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71601-6757
Mailing Address - Country:US
Mailing Address - Phone:870-868-1761
Mailing Address - Fax:
Practice Address - Street 1:1711 S MISSOURI ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71601-6714
Practice Address - Country:US
Practice Address - Phone:870-868-1761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula