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General NPI Number Information
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NPI Number | 1801809470
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Entity Type | Individual
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Provider Name | DAWNETTE PERSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 10200 TRINITY PKWY SUITE 102
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City | STOCKTON
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State | CA
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Zip | 95219-7286
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Country | US
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Telephone | 209-948-0808
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Fax | 209-948-0807
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Provider Business Mailing Address
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Address Line | P.O. BOX 241011
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City | LODI
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State | CA
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Zip | 95241-9511
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Country | US
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Telephone | 209-339-7825
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Fax | 209-339-7528
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN470138
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License Number State | CA
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