Provider Demographics
NPI:1295159085
Name:LEVASSEUR, DAWN M (FNP-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:LEVASSEUR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04937-1528
Mailing Address - Country:US
Mailing Address - Phone:207-859-3165
Mailing Address - Fax:207-859-3066
Practice Address - Street 1:121 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:ME
Practice Address - Zip Code:04937-1528
Practice Address - Country:US
Practice Address - Phone:207-859-3165
Practice Address - Fax:207-859-3066
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP141006363L00000X, 363LF0000X, 363LP2300X
SC20984363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1295159085Medicaid