MEDICARE: DAWN KORSON D-NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146N00000X	Basic Emergency Medical Technician	3203046140	MI
2	163W00000X	Registered Nurse	28235617A	IN
3	163W00000X	Registered Nurse	041.372695	IL
4	363LG0600X	Gerontology Nurse Practitioner	209.015571	IL
5	163W00000X	Registered Nurse	4704251540	MI
6	363LG0600X	Gerontology Nurse Practitioner	1224505	TX

General Provider Information

NPI Number	:	1114457892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN KORSON D-NP

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 UNIVERSITY BLVD STE 1710
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5149
Country	:	US
Telephone Number	:	317-944-5859
Fax Number	:	317-948-9939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2017
Last Update Date	:	02/05/2026

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