Healthcare Provider Details

I. General information

NPI: 1639534670
Provider Name (Legal Business Name): MARGARET ROSE DAWSON CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2015
Last Update Date: 12/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3038 W 850 S
BUNKER HILL IN
46914-9810
US

IV. Provider business mailing address

3038 W 850 S
BUNKER HILL IN
46914-9810
US

V. Phone/Fax

Practice location:
  • Phone: 765-689-8920
  • Fax:
Mailing address:
  • Phone: 765-689-8920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number28095438A
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: