Provider Demographics
NPI:1023316817
Name:COLLINS, DAWN MARIE (RN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 ARLINGTON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-1802
Mailing Address - Country:US
Mailing Address - Phone:419-689-3108
Mailing Address - Fax:
Practice Address - Street 1:548 ARLINGTON AVE APT 1
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-1802
Practice Address - Country:US
Practice Address - Phone:419-689-3108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.361828163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse