Provider Demographics
NPI:1952939142
Name:DAWES, LAURA RENEE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RENEE
Last Name:DAWES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 978
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:NH
Mailing Address - Zip Code:03851-0978
Mailing Address - Country:US
Mailing Address - Phone:603-507-3241
Mailing Address - Fax:
Practice Address - Street 1:38 DAWSON ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:NH
Practice Address - Zip Code:03851-4547
Practice Address - Country:US
Practice Address - Phone:603-507-3241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide