Provider Demographics
NPI:1144523259
Name:SOUZA, DAWN E (LPN)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:E
Last Name:SOUZA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 NIMITZ RD
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-1010
Mailing Address - Country:US
Mailing Address - Phone:508-287-3764
Mailing Address - Fax:
Practice Address - Street 1:17 NIMITZ RD
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:RI
Practice Address - Zip Code:02916-1010
Practice Address - Country:US
Practice Address - Phone:508-287-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN61156164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse