Healthcare Provider Details

I. General information

NPI: 1053349381
Provider Name (Legal Business Name): DAWN M. LUTZ MSN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN M BURNS MSN, CRNP

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 SEA MOUNTAIN HWY STE B
LITTLE RIVER SC
29566-8161
US

IV. Provider business mailing address

PO BOX 601743
CHARLOTTE NC
28260-1743
US

V. Phone/Fax

Practice location:
  • Phone: 843-366-3920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.31621
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: