Provider Demographics
NPI:1548866973
Name:DODD, DAWN RENEE (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:RENEE
Last Name:DODD
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3932 BAMBERG LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6048
Mailing Address - Country:US
Mailing Address - Phone:817-903-6879
Mailing Address - Fax:
Practice Address - Street 1:14350 PROTON RD
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-3511
Practice Address - Country:US
Practice Address - Phone:146-436-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty