MEDICARE: DAWN'S FIRST ASSISTANT INC.

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
1	163WR0006X	Registered Nurse First Assistant	110507	LA

General Provider Information

NPI Number	:	1932401593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAWN'S FIRST ASSISTANT INC.

Provider Business Mailing Address
First Line	:	PO BOX 45319
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70895-4319
Country	:	US
Telephone Number	:	225-505-3225
Fax Number	:	225-926-0935

Provider Business Practice Location Address
First Line	:	8508 GREENWELL SPRINGS RD
Second Line	:	APT 209
City	:	BATON ROUGE
State	:	LA
Zip	:	70814-2425
Country	:	US
Telephone Number	:	225-505-3225
Fax Number	:	225-926-0935

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DAWN DEBORRAH UKPONG
Credential	:	RNFA
Telephone Number	:	225-505-3225

Provider Enumeration Date	:	12/02/2010
Last Update Date	:	12/02/2010

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