Provider Demographics
NPI:1932430543
Name:COLBRY, DAWN MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:COLBRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 W LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-9711
Mailing Address - Country:US
Mailing Address - Phone:989-463-1993
Mailing Address - Fax:
Practice Address - Street 1:2600 THREE LEAVES DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-5523
Practice Address - Country:US
Practice Address - Phone:989-779-5600
Practice Address - Fax:989-772-4084
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703087155164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4703087155OtherLICENSE