=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992030696
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAWN SMITH WALSH APRN, AGNP, PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2009
-----------------------------------------------------
Last Update Date | 06/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14910 N. DALE MABRY HWY # 342203
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-820-4828
-----------------------------------------------------
Fax | 813-820-4977
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14910 N DALE MABRY HWY # 342203
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33618-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-820-4828
-----------------------------------------------------
Fax | 813-820-4977
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN11006514
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | APRN11006514
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN11006514
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------