Provider Demographics
NPI:1336855659
Name:DAWSON, CINNAMON RENEE (CNM)
Entity Type:Individual
Prefix:
First Name:CINNAMON
Middle Name:RENEE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:CINNAMON
Other - Middle Name:RENEE
Other - Last Name:GREENWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 748860
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374
Mailing Address - Country:US
Mailing Address - Phone:602-240-2401
Mailing Address - Fax:602-792-0244
Practice Address - Street 1:650 W MARYLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-1399
Practice Address - Country:US
Practice Address - Phone:602-240-2401
Practice Address - Fax:602-792-0244
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTEMP286319363L00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner