Healthcare Provider Details

I. General information

NPI: 1083486872
Provider Name (Legal Business Name): DAWN LEIGH NORDQUIST CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN BECK

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 GROUSE RD
PIERRE SD
57501-6127
US

IV. Provider business mailing address

124 GROUSE RD
PIERRE SD
57501-6127
US

V. Phone/Fax

Practice location:
  • Phone: 605-280-3940
  • Fax:
Mailing address:
  • Phone: 605-280-3940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCM000108
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: