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NPI Code Detail

MEDICARE: MRS. AMBER MARIE DAWSON FNP-C

MEDICARE: MRS. AMBER MARIE DAWSON FNP-C
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
1363LF0000XFamily Nurse PractitionerRN23200GA

General Provider Information

NPI Number : 1972273100
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMBER MARIE DAWSON FNP-C
Provider Business Mailing Address
First Line : 1140 GA HIGHWAY 64 E
Second Line :
City : PEARSON
State : GA
Zip : 31642-5645
Country : US
Telephone Number : 912-422-4648
Fax Number :
Provider Business Practice Location Address
First Line : 1101 OCILLA RD
Second Line :
City : DOUGLAS
State : GA
Zip : 31533-2262
Country : US
Telephone Number : 912-384-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2021
Last Update Date : 09/19/2021

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