Healthcare Provider Details

I. General information

NPI: 1770418246
Provider Name (Legal Business Name): MISTY LYNN DAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 POPLAR ST
MULLENS WV
25882-1026
US

IV. Provider business mailing address

1301 POPLAR ST
MULLENS WV
25882-1026
US

V. Phone/Fax

Practice location:
  • Phone: 681-474-2131
  • Fax:
Mailing address:
  • Phone: 681-474-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: