MEDICARE: DAWN NICHOL REESE REGISTERED NURSE

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	163W00000X	Registered Nurse	548896	CA
2	163WA2000X	Administrator Registered Nurse	548896	CA
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1225222102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN NICHOL REESE REGISTERED NURSE

Provider Business Mailing Address
First Line	:	PO BOX 472093
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94147-2093
Country	:	US
Telephone Number	:	916-832-5803
Fax Number	:

Provider Business Practice Location Address
First Line	:	1028 GIRARD RD APT 422
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94129-6506
Country	:	US
Telephone Number	:	916-832-5803
Fax Number	:

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

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	07/27/2023

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