Provider Demographics
NPI:1245742840
Name:DEESPINO, DAWN MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:DEESPINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:7815 PINE DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033-1149
Mailing Address - Country:US
Mailing Address - Phone:931-729-4307
Mailing Address - Fax:
Practice Address - Street 1:7815 PINE DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1149
Practice Address - Country:US
Practice Address - Phone:931-994-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000096072163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy