Healthcare Provider Details

I. General information

NPI: 1255713236
Provider Name (Legal Business Name): JOSIE ANNE DAWE RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOSIE ANNE JUDD

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 WEAVER PKWY STE 102
WARRENVILLE IL
60555-3864
US

IV. Provider business mailing address

12922 TIMBER WOOD CIR
PLAINFIELD IL
60585-2950
US

V. Phone/Fax

Practice location:
  • Phone: 630-839-9199
  • Fax: 630-839-9299
Mailing address:
  • Phone: 815-326-2615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number377001720
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number27700177
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0413363418
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: