=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104133560
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CYNTHIA ANN DAWSON RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2010
-----------------------------------------------------
Last Update Date | 09/08/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 65 VALLEY RD
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02842-5234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-846-1213
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21 DEAN ST
-----------------------------------------------------
City | ASSONET
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02702-1215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-218-9106
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN48591
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------