Provider Demographics
NPI:1841832136
Name:DAWSON, NIKI (SOLE PROPRIETOR)
Entity type:Individual
Prefix:
First Name:NIKI
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:SOLE PROPRIETOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 LYMAN ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-4531
Mailing Address - Country:US
Mailing Address - Phone:413-923-2133
Mailing Address - Fax:
Practice Address - Street 1:39 BELMONT ST # 3R
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-1914
Practice Address - Country:US
Practice Address - Phone:413-923-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty