Healthcare Provider Details

I. General information

NPI: 1174469324
Provider Name (Legal Business Name): DAWN SKINNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 S TYNDALL RD
BRANCH MI
49402-9473
US

IV. Provider business mailing address

758 S TYNDALL RD
BRANCH MI
49402-9473
US

V. Phone/Fax

Practice location:
  • Phone: 231-898-6260
  • Fax:
Mailing address:
  • Phone: 231-898-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAF430416344
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: