Healthcare Provider Details

I. General information

NPI: 1023420841
Provider Name (Legal Business Name): ROLITTA MARSHALL DAWSON MSN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 3RD ST
GREENSBORO NC
27405-6967
US

IV. Provider business mailing address

1908 LENDEW ST
GREENSBORO NC
27408-7007
US

V. Phone/Fax

Practice location:
  • Phone: 336-890-3200
  • Fax: 336-890-3290
Mailing address:
  • Phone: 336-273-2835
  • Fax: 336-273-1948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM 540
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: