Healthcare Provider Details

I. General information

NPI: 1710173554
Provider Name (Legal Business Name): DAWN PAONE RN, APN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 NEW JERSEY AVE
WILDWOOD CREST NJ
08260-1216
US

IV. Provider business mailing address

49 JILL AVE
MARMORA NJ
08223-1152
US

V. Phone/Fax

Practice location:
  • Phone: 609-523-1331
  • Fax: 609-522-1516
Mailing address:
  • Phone: 609-390-8485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00141000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: