Provider Demographics
NPI:1144468331
Name:ARMSTRONG, DAWN GEDRA (LPN/RN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:GEDRA
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:LPN/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 GOULD AVE
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-3027
Mailing Address - Country:US
Mailing Address - Phone:716-583-1745
Mailing Address - Fax:
Practice Address - Street 1:3095 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2500
Practice Address - Country:US
Practice Address - Phone:716-833-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY587788163W00000X
NY237880164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse