Provider Demographics
NPI:1184981615
Name:MANSFIELD, DAWN SARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:SARIE
Last Name:MANSFIELD
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 1:650 BOWHALL RD
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-4828
Mailing Address - Country:US
Mailing Address - Phone:440-231-9408
Mailing Address - Fax:
Practice Address - Street 1:650 BOWHALL RD
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-4828
Practice Address - Country:US
Practice Address - Phone:440-231-9408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-22
Last Update Date:2012-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-143799-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse