Healthcare Provider Details
I. General information
NPI: 1760466882
Provider Name (Legal Business Name): DAWN M ESTES RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/01/2005
Last Update Date: 12/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
409 W AUBERRY GRV
JAMESPORT MO
64648-7189
US
IV. Provider business mailing address
1600 E EVERGREEN ST PO BOX 557
CAMERON MO
64429-2400
US
V. Phone/Fax
- Phone: 660-684-6252
- Fax: 660-684-6254
- Phone: 816-632-2101
- Fax: 816-649-3383
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 128609 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: