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General NPI Number Information
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NPI Number | 1952397952
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Entity Type | Individual
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Provider Name | DAWN LESLIE EVERT NP
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Gender | Female
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Dates
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Enumeration Date | 09/25/2005
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 900 INDIANA AVE STE D
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City | PUEBLO
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State | CO
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Zip | 81004-3767
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Country | US
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Telephone | 719-924-9021
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Fax | 719-924-9166
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Provider Business Mailing Address
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Address Line | 900 INDIANA AVE STE D
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City | PUEBLO
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State | CO
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Zip | 81004-3767
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Country | US
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Telephone | 719-924-9021
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Fax | 719-924-9166
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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 | 4650
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 81123
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License Number State | CO
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