Healthcare Provider Details

I. General information

NPI: 1831016039
Provider Name (Legal Business Name): DAWN MARIE MILLER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 TIFFANY DR
MASON CITY IA
50401-1535
US

IV. Provider business mailing address

478 TIFFANY DR
MASON CITY IA
50401-1535
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-5000
  • Fax: 641-494-5028
Mailing address:
  • Phone: 641-494-5000
  • Fax: 641-494-5028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberP27164
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: