Provider Demographics
NPI:1134951544
Name:MATTHEWS, DAWN ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ANN
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:ANN
Other - Last Name:GRACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2096 N STATE RD LOT 109
Mailing Address - Street 2:
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-9565
Mailing Address - Country:US
Mailing Address - Phone:517-732-8175
Mailing Address - Fax:
Practice Address - Street 1:2096 N STATE RD LOT 109
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-9565
Practice Address - Country:US
Practice Address - Phone:517-732-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty