Healthcare Provider Details

I. General information

NPI: 1538497946
Provider Name (Legal Business Name): DAWN PASQUARELLO BURKS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN M HEYWARD NP

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 GORDON HWY STE 17A
AUGUSTA GA
30906-2229
US

IV. Provider business mailing address

PO BOX 740015
ATLANTA GA
30374-0015
US

V. Phone/Fax

Practice location:
  • Phone: 706-230-7006
  • Fax: 762-257-7442
Mailing address:
  • Phone: 312-733-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3773
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberGAA-NP000160
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: