Provider Demographics
NPI:1952909277
Name:JOHNSON, DAWN M (CNP, DNP)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BELOIT HEALTH SYSTEMS INC.
Mailing Address - Street 2:1969 W HART ROAD
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2230
Mailing Address - Country:US
Mailing Address - Phone:608-364-2293
Mailing Address - Fax:608-364-5452
Practice Address - Street 1:BELOIT CLINIC
Practice Address - Street 2:1905 E HUEBBE PARKWAY
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1842
Practice Address - Country:US
Practice Address - Phone:608-364-2230
Practice Address - Fax:608-363-7394
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1555745163WG0600X
IL209-021132363L00000X
MN6909363LF0000X
WI10710-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100227572Medicaid