Provider Demographics
NPI:1952601437
Name:DAWSON, DEANNA (RPH)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 N HUNT HWY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-6894
Mailing Address - Country:US
Mailing Address - Phone:520-723-4885
Mailing Address - Fax:520-723-2972
Practice Address - Street 1:3325 N HUNT HWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-6894
Practice Address - Country:US
Practice Address - Phone:520-723-4885
Practice Address - Fax:520-723-2972
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS013268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist