Healthcare Provider Details

I. General information

NPI: 1699664029
Provider Name (Legal Business Name): DAWN SHAMKIN AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 E RIVER RD
TUCSON AZ
85718-6632
US

IV. Provider business mailing address

2626 E RIVER RD
TUCSON AZ
85718-6632
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-7021
  • Fax:
Mailing address:
  • Phone: 520-694-7021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number345485
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: