MEDICARE: MRS. DAWN MARIE LARRIUZ RN

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	163WH0200X	Home Health Registered Nurse	RN337870	OH

General Provider Information

NPI Number	:	1497994974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN MARIE LARRIUZ RN

Provider Business Mailing Address
First Line	:	23695 STATE ROUTE 347
Second Line	:
City	:	WEST MANSFIELD
State	:	OH
Zip	:	43358-9667
Country	:	US
Telephone Number	:	262-716-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	23695 STATE ROUTE 347
Second Line	:
City	:	WEST MANSFIELD
State	:	OH
Zip	:	43358-9667
Country	:	US
Telephone Number	:	262-716-7406
Fax Number	:

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

Provider Enumeration Date	:	02/06/2009
Last Update Date	:	02/06/2009

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