Provider Demographics
NPI:1134562077
Name:RABIEGO, DAWN MICHELLE (LPN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:RABIEGO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7262 FARWELL RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-9425
Mailing Address - Country:US
Mailing Address - Phone:920-203-1219
Mailing Address - Fax:
Practice Address - Street 1:N7262 FARWELL RD
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-9425
Practice Address - Country:US
Practice Address - Phone:920-203-1219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI309212-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse