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NPI Code Detail

MEDICARE: DAWN EVERLINE L.P.N

MEDICARE:   DAWN  EVERLINE  L.P.N
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse302129NY

General Provider Information

NPI Number : 1811272321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN EVERLINE L.P.N
Provider Business Mailing Address
First Line : 1385 STEBBINS AVE # 306
Second Line :
City : BRONX
State : NY
Zip : 10459-1310
Country : US
Telephone Number : 718-612-3914
Fax Number :
Provider Business Practice Location Address
First Line : 1385 STEBBINS AVE # 306
Second Line :
City : BRONX
State : NY
Zip : 10459-1310
Country : US
Telephone Number : 718-612-3914
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2011
Last Update Date : 10/15/2011

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Directions to “ DAWN EVERLINE L.P.N” Practice Location

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