Provider Demographics
NPI:1255713236
Name:DAWE, JOSIE ANNE (RN, CPNP)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:ANNE
Last Name:DAWE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:ANNE
Other - Last Name:JUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12922 TIMBER WOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2950
Mailing Address - Country:US
Mailing Address - Phone:815-326-2615
Mailing Address - Fax:
Practice Address - Street 1:4580 WEAVER PKWY STE 102
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3864
Practice Address - Country:US
Practice Address - Phone:630-839-9199
Practice Address - Fax:630-839-9299
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0413363418163W00000X
IL377001720363LP0222X
IL27700177363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care