Provider Demographics
NPI:1770334955
Name:ADAM, DAWN K
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:K
Last Name:ADAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22115 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CASSOPOLIS
Mailing Address - State:MI
Mailing Address - Zip Code:49031-9549
Mailing Address - Country:US
Mailing Address - Phone:269-445-8739
Mailing Address - Fax:
Practice Address - Street 1:22115 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:CASSOPOLIS
Practice Address - State:MI
Practice Address - Zip Code:49031-9549
Practice Address - Country:US
Practice Address - Phone:269-445-8739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide