Healthcare Provider Details

I. General information

NPI: 1760573778
Provider Name (Legal Business Name): SACHA DAWN DAWKINS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 COLLEGE ST
COLUMBUS MS
39701-5800
US

IV. Provider business mailing address

1483 STEEDLEY RD
MILLPORT AL
35576-3310
US

V. Phone/Fax

Practice location:
  • Phone: 662-329-7289
  • Fax:
Mailing address:
  • Phone: 205-662-3676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR851902
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-076308
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: