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General NPI Number Information
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NPI Number | 1245866425
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Entity Type | Individual
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Provider Name | DAWN DANETTE PEAK APRN
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Gender | Female
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 340 THOMAS MORE PKWY STE 260
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-5117
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Country | US
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Telephone | 859-957-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 525 GABRIELLA CT
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City | BURLINGTON
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State | KY
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Zip | 41005-6574
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Country | US
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Telephone | 757-574-2426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3014462
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License Number State | KY
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