Healthcare Provider Details

I. General information

NPI: 1518497429
Provider Name (Legal Business Name): KAREN POOLE-DAWKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 06/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 DENADA PATH
DURHAM NC
27707-6040
US

IV. Provider business mailing address

3401 DENADA PATH
DURHAM NC
27707-6040
US

V. Phone/Fax

Practice location:
  • Phone: 919-265-3226
  • Fax:
Mailing address:
  • Phone: 919-265-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number67280
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: