Provider Demographics
NPI:1932265501
Name:DIMITRI, DAWN
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:DIMITRI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:14310 AIKEN RIDE VW
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80926-9613
Mailing Address - Country:US
Mailing Address - Phone:931-217-2766
Mailing Address - Fax:
Practice Address - Street 1:1650 COCHRANE CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:931-217-2766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664863163WX0003X
TXAP121614176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP121614OtherNURSE MIDWIFE TX LICENCE NUMBER