Provider Demographics
NPI:1245415074
Name:MCCUTCHEON, DAWN M (RN)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:ZINGESER
Other - Last Name:MCCUTCHEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:229 CAYUTA ST
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-9503
Mailing Address - Country:US
Mailing Address - Phone:570-888-0632
Mailing Address - Fax:
Practice Address - Street 1:1 GUTHRIE SQUARE
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840
Practice Address - Country:US
Practice Address - Phone:570-888-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN500519L163W00000X
NY22463747163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse