Provider Demographics
NPI:1821815523
Name:PICKETT, DAWN M (MSN, RN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:PICKETT
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-9224
Mailing Address - Country:US
Mailing Address - Phone:716-483-4430
Mailing Address - Fax:
Practice Address - Street 1:195 MARTIN RD
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-9224
Practice Address - Country:US
Practice Address - Phone:716-483-4430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY593966163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse