Healthcare Provider Details

I. General information

NPI: 1265604797
Provider Name (Legal Business Name): DAWN WINCHESTER MARTIN NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWTHORNE LN
CHARLOTTE NC
28204-2515
US

IV. Provider business mailing address

1009 BAYBROOK DR
WAXHAW NC
28173-7061
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-4944
  • Fax:
Mailing address:
  • Phone: 303-396-5194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number172404
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number1026662
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number5020418
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: