Provider Demographics
NPI:1538985700
Name:DUSEK, DAWN KYLIE (RN)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:KYLIE
Last Name:DUSEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12704 CR 1388
Mailing Address - Street 2:
Mailing Address - City:EOLA
Mailing Address - State:TX
Mailing Address - Zip Code:76937
Mailing Address - Country:US
Mailing Address - Phone:325-234-5581
Mailing Address - Fax:
Practice Address - Street 1:SHANNON MEDICAL CENTER
Practice Address - Street 2:120 E. HARRIS AVE.
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903
Practice Address - Country:US
Practice Address - Phone:325-747-6741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX729187163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse