Healthcare Provider Details

I. General information

NPI: 1962690313
Provider Name (Legal Business Name): DAWN S MONAHAN APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS DAWN LEE SAWRUN

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06030-8040
US

IV. Provider business mailing address

263 FARMINGTON AVE
FARMINGTON CT
06030-8082
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-2100
  • Fax:
Mailing address:
  • Phone: 860-679-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number003644
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number3644
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: