MEDICARE: DAWN AUSTERMAN

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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1659726107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN AUSTERMAN

Provider Business Mailing Address
First Line	:	PO BOX 8584
Second Line	:
City	:	KODIAK
State	:	AK
Zip	:	99615-8584
Country	:	US
Telephone Number	:	907-942-7302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1912 MILL BAY RD LOT 4
Second Line	:
City	:	KODIAK
State	:	AK
Zip	:	99615-6673
Country	:	US
Telephone Number	:	907-942-7302
Fax Number	:

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	05/03/2016

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Directions to “ DAWN AUSTERMAN ” Practice Location

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